Mapping cerebellar degeneration in HIV/AIDS.
Progressive brain atrophy in HIV/AIDS is associated with impaired psychomotor performance, perhaps partly reflecting cerebellar degeneration; yet little is known about how HIV/AIDS affects the cerebellum. We visualized the three-dimensional profile of atrophy in 19 HIV-positive patients (age: 42.9+/-8.3 years) versus 15 healthy controls (age: 38.5+/-12.0 years). We localized consistent patterns of subregional atrophy with an image analysis method that automatically deforms each patient's scan, in three dimensions, to match a reference image. Atrophy was greatest in the posterior cerebellar vermis (14.9% deficit) and correlated with depression severity (P=0.009, corrected), but not with dementia, alcohol/substance abuse, CD4+T-cell counts, or viral load. Profound cerebellar deficits in HIV/AIDS (P=0.007, corrected) were associated with depression, suggesting a surrogate disease marker for antiretroviral trials.
Klunder
Andrea D
AD
Laboratory of Neuro Imaging, Department of Neurology, UCLA School of Medicine, Los Angeles, California 90095-7332, USA.
Chiang
Ming-Chang
MC
Dutton
Rebecca A
RA
Lee
Sharon E
SE
Toga
Arthur W
AW
Lopez
Oscar L
OL
Aizenstein
Howard J
HJ
Becker
James T
JT
Thompson
Paul M
PM
D015526:AIDS Dementia Complex / Q000209:etiology / Q000503:physiopathology; D000163:Acquired Immunodeficiency Syndrome / Q000150:complications / Q000503:physiopathology*; D000328:Adult; D001284:Atrophy; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003863:Depression / Q000209:etiology / Q000503:physiopathology; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000503:physiopathology*; D006679:HIV Seropositivity / Q000097:blood / Q000150:complications / Q000821:virology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013132:Spinocerebellar Degenerations / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D019966:Substance-Related Disorders / Q000209:etiology / Q000503:physiopathology; D019562:Viral Load