Bone marrow diffusion measures correlate with dementia severity in HIV patients.
OBJECTIVE
Escalation in monocyte trafficking from the bone marrow into the brain may play a critical role in central nervous system injury and cognitive deterioration in patients with HIV infection. This study tested the hypothesis that the mean diffusivity is sensitive to marrow changes in HIV patients and that these quantitative imaging measurements correlate with the severity of dementia.


METHODS
The mean diffusivity (MD), determined for clival and calvarial marrow regions, was compared in 11 HIV-infected patients and 9 control subjects. The imaging measurements were also evaluated for relationships with dementia severity and markers of disease progression (CD4 and viral load in plasma).


RESULTS
The MD was significantly reduced in both clival and calvarial marrow in HIV-infected patients (P =.006). Diffusion measurements for clival (P =.02) and for calvarial (P =.03) regions were significantly correlated with the severity of dementia.


CONCLUSIONS
The results of this investigation support the utility of diffusion strategies for monitoring the marrow and provide further evidence of a relationship between marrow status changes and neurologic progression in HIV patients.
Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Ill, USA.
A B
AB
Ragin
Y
Y
Wu
P
P
Storey
B A
BA
Cohen
R R
RR
Edelman
L G
LG
Epstein
S
S
Gartner
D015526:AIDS Dementia Complex / Q000473:pathology*; D001853:Bone Marrow / Q000473:pathology*; D005260:Female; D006679:HIV Seropositivity / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index