title: Case control study: magnetic resonance spectroscopy of brain in HIV infected patients.
abstract: BACKGROUND
  In vivo proton magnetic resonance spectroscopy ((1)H-MRS) studies on brain in HIV infected patients have shown significant alteration in neuro-biochemicals.
  
  
  METHODS
  In this study, we measured the neuro-biochemical metabolites from the left frontal white matter (FWM) and left basal ganglia (BG) caudate head nucleus in 71 subjects that include 30 healthy controls, 20 asymptomatic HIV and 21 HIV patients with CNS lesion. Proton MR spectra were acquired at 3 T MRI system and the concentration (institutional units) of tNAA (N-acetylaspartate, NAA + N-acetylaspartylglutamate, NAAG), tCr (Creatine, Cr + phosphocreatine, PCr), choline containing compounds (tCho), glutamate + glutamine (Glx) and lipid and macromolecules at 0.9 ppm were determined using LC Model.
  
  
  RESULTS
  In BG, the concentration of tNAA (6.71 ± 0.64) was decreased and in FWM, the concentration of Glx (20.4 ± 7.8), tCr (9.14 ± 3.04) and lipid and macromolecules at 0.9 ppm (8.69 ± 2.96) were increased in HIV patients with CNS lesion. In healthy controls, the concentration of tNAA in BG was 7.31 ± 0.47 and concentration of Glx, tCr and lipid and macromolecules in FWM were 15.0 ± 6.06, 6.95 ± 2.56, 5.59 ± 1.56, respectively.
  
  
  CONCLUSIONS
  Reduced tNAA in BG suggests neuronal loss in HIV patients with CNS lesion while increased Glx in FWM may suggest excito-toxicity. In addition, increased levels of tCr in FWM of HIV patients were observed. The study indicates region specific metabolic changes in tNAA, tCr and Glx in brain of HIV infected patients.
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Devender
authors.initials: D
authors.lastname: Bairwa
authors.affiliation: Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Virendra
authors.initials: V
authors.lastname: Kumar
authors.affiliation: Department of Radio-diagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Surabhi
authors.initials: S
authors.lastname: Vyas
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Bimal Kumar
authors.initials: BK
authors.lastname: Das
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Achal Kumar
authors.initials: AK
authors.lastname: Srivastava
authors.affiliation: Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Ravinder M
authors.initials: RM
authors.lastname: Pandey
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Sharma
authors.affiliation: Department of NMR & MRI Facility, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
authors.forename: Naranamangalam R
authors.initials: NR
authors.lastname: Jagannathan
authors.affiliation: Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. drsanjeevsinha@gmail.com.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Sinha
mesh_terms: D000328:Adult; D001224:Aspartic Acid / Q000031:analogs & derivatives / Q000378:metabolism; D001479:Basal Ganglia / Q000378:metabolism*; D016022:Case-Control Studies; D002794:Choline / Q000378:metabolism; D003401:Creatine / Q000378:metabolism; D004151:Dipeptides / Q000378:metabolism; D005260:Female; D005625:Frontal Lobe / Q000378:metabolism*; D018698:Glutamic Acid / Q000378:metabolism; D005973:Glutamine / Q000378:metabolism; D015658:HIV Infections / Q000378:metabolism*; D006801:Humans; D007294:Inositol / Q000378:metabolism; D050356:Lipid Metabolism; D046911:Macromolecular Substances / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D066244:Proton Magnetic Resonance Spectroscopy; D066127:White Matter / Q000378:metabolism
chemical_list: D004151:Dipeptides; D046911:Macromolecular Substances; D005973:Glutamine; C027172:isospaglumic acid; D001224:Aspartic Acid; D018698:Glutamic Acid; D007294:Inositol; C000179:N-acetylaspartate; D003401:Creatine; D002794:Choline
keywords: AIDS; Glutamate; HIV; MRS; Magnetic resonance spectroscopy