Original Research Changes in Cerebral Metabolism Are Detected Prior to Perfusion Changes in.pdfVIP

JOURNAL OF MAGNETIC RESONANCE IMAGING 12:859–865 (2000) Original Research Changes in Cerebral Metabolism Are Detected Prior to Perfusion Changes in Early HIV-CMC: A Coregistered 1H MRS and SPECT Study Thomas Ernst, PhD, 1,2* Emmanuel Itti, MD,2 Laurent Itti, PhD,2 and Linda Chang, MD2 Human immunodeficiency virus-cognitive motor complex THE SYNDROME of human immunodeficiency virus- (HIV-CMC), a common complication of the acquired immu- cognitive motor xomplex (HIV-CMC) (1,2) occurs in nodeficiency syndrome (AIDS), is characterized by pro- 10%–20% of patients with the acquired immunodefi- gressive cognitive impairment and motor dysfunction. ciency dyndrome (AIDS) (3) . With highly active antiret- Functional imaging methods, such as single-photon emis- roviral therapy (HAART), the incidence of HIV-CMC is sion computed tomography (SPECT) and proton magnetic reduced by approximately 30% (4); however, it is un- resonance spectroscopy (1H-MRS), have been applied to known whether this reduced rate will remain stable. assess the severity of brain injury. However, it is unclear Clinically, patients with HIV-CMC develop progressive which of these two methods is more sensitive in detecting cognitive impairment and motor dysfunction (5,6). brain abnormalities in patients with early HIV-CMC. Twen- ty-four HIV-CMC patients were compared with 34 healthy These symptoms may be related to the indirect effects of subjects; each had quantitative SPECT (133Xenon-calibrat- virally induced cytokines or the direct effect of HIV-1 ed 99mTc-HMPAO) and quantitative 1H-MRS. Both modali- viral proteins, which are