title: HIV-associated neurodegeneration and neuroimmunity: multivoxel MR spectroscopy study in drug-naïve and treated patients.
abstract: OBJECTIVE
  The aim of this study was to test neurobiochemical changes in normal appearing brain tissue in HIV+ patients receiving and not receiving combined antiretroviral therapy (cART) and healthy controls, using multivoxel MR spectroscopy (mvMRS).
  
  
  METHODS
  We performed long- and short-echo 3D mvMRS in 110 neuroasymptomatic subjects (32 HIV+ subjects on cART, 28 HIV+ therapy-naïve subjects and 50 healthy controls) on a 3T MR scanner, targeting frontal and parietal supracallosal subcortical and deep white matter and cingulate gyrus (NAA/Cr, Cho/Cr and mI/Cr ratios were analysed). The statistical value was set at p < 0.05.
  
  
  RESULTS
  Considering differences between HIV-infected and healthy subjects, there was a significant decrease in the NAA/Cr ratio in HIV+ subjects in all observed locations, an increase in mI/Cr levels in the anterior cingulate gyrus (ACG), and no significant differences in Cho/Cr ratios, except in ACG, where the increase showed trending towards significance in HIV+ patients. There were no significant differences between HIV+ patients on and without cART in all three ratios.
  
  
  CONCLUSIONS
  Neuronal loss and dysfunction affects the whole brain volume in HIV-infected patients. Unfortunately, cART appears to be ineffective in halting accelerated neurodegenerative process induced by HIV but is partially effective in preventing glial proliferation.
  
  
  CONCLUSIONS
  • This is the first multivoxel human brain 3T MRS study in HIV. • All observed areas of the brain are affected by neurodegenerative process. • Cingulate gyrus and subcortical white matter are most vulnerable to HIV-induced neurodegeneration. • cART is effective in control of inflammation but ineffective in preventing neurodegeneration.
authors.affiliation: Faculty of Medicine, Vojvodina Institute of Oncology, Diagnostic Imaging Center, University of Novi Sad, 21204, Sremska Kamenica, Novi Sad, Serbia. jasmina.boban@mf.uns.ac.rs.
authors.forename: Jasmina
authors.identifier: http://orcid.org/0000-0001-9701-5484
authors.initials: J
authors.lastname: Boban
authors.affiliation: Faculty of Medicine, Vojvodina Institute of Oncology, Diagnostic Imaging Center, University of Novi Sad, 21204, Sremska Kamenica, Novi Sad, Serbia.
authors.forename: Dusko
authors.initials: D
authors.lastname: Kozic
authors.affiliation: Clinic for Infectious Diseases, Clinical Centre of Vojvodina, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.
authors.forename: Vesna
authors.initials: V
authors.lastname: Turkulov
authors.affiliation: Faculty of Medicine, Clinical Center of Vojvodina, Department of Radiology, University of Novi Sad, Novi Sad, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Ostojic
authors.affiliation: Faculty of Medicine, Vojvodina Institute of Oncology, Diagnostic Imaging Center, University of Novi Sad, 21204, Sremska Kamenica, Novi Sad, Serbia.
authors.forename: Robert
authors.initials: R
authors.lastname: Semnic
authors.affiliation: Clinic for Infectious Diseases, Clinical Centre of Vojvodina, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.
authors.forename: Dajana
authors.initials: D
authors.lastname: Lendak
authors.affiliation: Clinic for Infectious Diseases, Clinical Centre of Vojvodina, University of Novi Sad, Faculty of Medicine, Novi Sad, Serbia.
authors.forename: Snezana
authors.initials: S
authors.lastname: Brkic
mesh_terms: D015526:AIDS Dementia Complex / Q000000981:diagnostic imaging*; D000328:Adult; D001224:Aspartic Acid / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism; D016022:Case-Control Studies; D002794:Choline / Q000032:analysis; D003401:Creatine / Q000032:analysis; D005260:Female; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D009682:Magnetic Resonance Spectroscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D012189:Retrospective Studies; D066127:White Matter / Q000000981:diagnostic imaging; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001224:Aspartic Acid; D003401:Creatine; D002794:Choline
keywords: AIDS dementia complex; Brain; Brain damage, chronic; Highly active antiretroviral therapy; Magnetic resonance spectroscopy