title: Two-dimensional 1H MR spectroscopy of the brain in human immunodeficiency virus (HIV)-infected children.
abstract: OBJECTIVE
  To measure cerebral metabolites in brains of human immunodeficiency virus (HIV)-infected patients using two-dimensional (2D) proton ((1)H) magnetic resonance spectroscopy (MRS), which enables more sensitive detection of metabolites at lower concentrations and delineation of the components of the different choline (Ch) groups in the frequency domain when compared to one dimensional (1D) (1)H-MRS.
  
  
  METHODS
  We examined metabolite/creatine (Cr) and metabolite/Ch ratios in the left frontal brain of 10 HIV-infected (mean age 13.7 +/- 4.7 years) and 11 control (mean age 15.3 +/- 4.6 years) adolescents and children using 2D localized chemical shift correlated spectroscopy (L-COSY). The integrated volume under each 2D metabolite peak was calculated with reference to the diagonal creatine methyl peak (Cr_d) or the diagonal choline trimethylamine peak (Ch_d).
  
  
  RESULTS
  In the HIV-infected patients, myoinositol (mI)/Cr_d (P = 0.009) and mI/Ch_d (P = 0.006) were elevated. The ratios of the following metabolites were also significantly elevated (P < 0.05): mI-Ch/Cr_d, gamma-aminobutyrate (GABA)/ Cr_d, GABA/Ch_d, threonine-lactate (Thr-Lac)/Cr_d, Thr-Lac/Ch_d, and N-acetyl aspartate (NAA)/Cr_d.
  
  
  CONCLUSIONS
  We have demonstrated for the first time the feasibility of 2D-MRS in HIV-infected children and adolescents to assess cerebral metabolites and found elevated mI and elevated GABA, in the left frontal brain of clinically stable HIV-infected patients. A larger study population is needed to confirm these pilot GABA findings.
authors.affiliation: Department of Pediatrics, Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles (UCLA) Medical Center, California, USA.
authors.forename: Shida
authors.initials: S
authors.lastname: Banakar
authors.forename: M Albert
authors.initials: MA
authors.lastname: Thomas
authors.forename: Audra
authors.initials: A
authors.lastname: Deveikis
authors.forename: June Q Y
authors.initials: JQ
authors.lastname: Watzl
authors.forename: Judy
authors.initials: J
authors.lastname: Hayes
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Keller
mesh_terms: D000293:Adolescent; D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D002648:Child; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D015658:HIV Infections / Q000378:metabolism*; D006801:Humans; D007294:Inositol / Q000378:metabolism; D009682:Magnetic Resonance Spectroscopy; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
chemical_list: D001224:Aspartic Acid; D007294:Inositol; D005680:gamma-Aminobutyric Acid; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline