title: Cerebral microglia activation in hepatitis C virus infection correlates to cognitive dysfunction.
abstract: Hepatitis C virus (HCV) infection may induce chronic fatigue and cognitive dysfunction. Virus replication was proven within the brain and HCV-positive cells were identified as microglia and astrocytes. We hypothesized that cerebral dysfunction in HCV-afflicted patients is associated with microglia activation. Microglia activation was assessed in vivo in 22 patients with chronic HCV infection compared to six healthy controls using [(11) C]-PK11195 Positron Emission Tomography (PET) combined with magnetic resonance tomography for anatomical localization. Patients were subdivided with regard to their PCR status, Fatigue Impact Scale score (FIS) and attention test sum score (ATS). A total of 12 patients (54.5%) were HCV PCR positive [of which 7 (58.3%) had an abnormal FIS and 7 (58.3%) an abnormal ATS], 10 patients (45.5%) were HCV PCR negative (5 (50%) each with an abnormal FIS or ATS). Patients without attention deficits showed a significantly higher accumulation of [(11) C]-PK11195 in the putamen (P = 0.05), caudate nucleus (P = 0.03) and thalamus (P = 0.04) compared to controls. Patients with and without fatigue did not differ significantly with regard to their specific tracer binding in positron emission tomography. Preserved cognitive function was associated with significantly increased microglia activation with predominance in the basal ganglia. This indicates a probably neuroprotective effect of microglia activation in HCV-infected patients.
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.|Integrated Research and Treatment Centre Transplantation, Hannover Medical School, Hannover, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Pflugrad
authors.affiliation: Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: G-J
authors.initials: GJ
authors.lastname: Meyer
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Dirks
authors.affiliation: Department of Diagnostic and Interventional Neuroradiology, Hannover Medical School, Hannover, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Raab
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.|Integrated Research and Treatment Centre Transplantation, Hannover Medical School, Hannover, Germany.
authors.forename: A B
authors.initials: AB
authors.lastname: Tryc
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.|Integrated Research and Treatment Centre Transplantation, Hannover Medical School, Hannover, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Goldbecker
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.
authors.forename: H
authors.initials: H
authors.lastname: Worthmann
authors.affiliation: Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Wilke
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: R
authors.initials: R
authors.lastname: Boellaard
authors.affiliation: Department of Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Yaqub
authors.affiliation: Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany.
authors.forename: G
authors.initials: G
authors.lastname: Berding
authors.affiliation: Department of Neurology, Hannover Medical School, Hannover, Germany.|Integrated Research and Treatment Centre Transplantation, Hannover Medical School, Hannover, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Weissenborn
mesh_terms: D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging; D060825:Cognitive Dysfunction; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D017628:Microglia / Q000276:immunology*; D008875:Middle Aged; D049268:Positron-Emission Tomography
keywords: [11C]-PK11195; cognitive impairment; fatigue; microglia; positron emission tomography