Neuropsychological function and cerebral metabolites in HIV-infected youth.
The effects of HIV on brain metabolites and cognitive function are not well understood. Sixteen HIV+youths (15 vertical, 1 transfusion transmissions) receiving combination antiretroviral therapy and 14 age-matched HIV- youths (13-25 years of age) were evaluated with brain two-dimensional (2D) magnetic resonance spectroscopy (MRS) at 3 Tesla (T) and a neuropsychological battery that assessed three cognitive domains (attention/processing speed, psychomotor ability, and executive function). The relationship between brain metabolite ratios and cognitive performance was explored. Compared to HIV- controls, HIV+ subjects had higher sycllo-inositol (Scy)/total creatine (tCr) (+32%, p = 0.016) and higher Scy/total choline (tCho) (+31%, p = 0.018) on 2D-MRS in the right frontal lobe. HIV+ subjects also had higher glutamate (Glu)/tCr (+13%, p = 0.022) and higher Glu/tCho (+15%, p = 0.048) than controls. HIV+ subjects demonstrated poorer attention/processing speed (p = 0.011, d = 1.03) but similar psychomotor and executive function compared to HIV- controls. The attention/processing score also correlated negatively with the ratio of N-acetylaspartate (NAA) to tCr on 2D-MRS (r = -0.75, p = 0.0019) in the HIV- controls, but not in the HIV+ subjects (Fisher's r-z transformation, p < 0.05). Our results suggest that attention/processing speed is impacted by early HIV infection and is associated with right hemisphere NAA/tCr. Scy and Glu ratios are also potential markers of brain health in chronic, lifelong HIV infection in perinatally infected youths receiving antiretroviral therapy.
David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, CA, USA.
R
R
Nagarajan
M K
MK
Sarma
M A
MA
Thomas
L
L
Chang
U
U
Natha
M
M
Wright
J
J
Hayes
K
K
Nielsen-Saines
D E
DE
Michalik
J
J
Deville
J A
JA
Church
K
K
Mason
T
T
Critton-Mastandrea
S
S
Nazarian
J
J
Jing
M A
MA
Keller
D000293:Adolescent; D000596:Amino Acids / Q000097:blood; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000097:blood; D001923:Brain Chemistry / Q000502:physiology*; D018791:CD4 Lymphocyte Count; D002648:Child; D003071:Cognition / Q000502:physiology; D005260:Female; D005625:Frontal Lobe / Q000473:pathology; D015658:HIV Infections / Q000378:metabolism* / Q000523:psychology*; D006679:HIV Seropositivity / Q000378:metabolism / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D011340:Problem Solving; D011597:Psychomotor Performance / Q000502:physiology; D055815:Young Adult
D000596:Amino Acids; D001224:Aspartic Acid; C000179:N-acetylaspartate