TY - JOUR
T1 - Brain choline-containing compounds are elevated in HIV-positive patients before the onset of AIDS dementia complex
T2 - A proton magnetic resonance spectroscopic study
AU - Tracey, I.
AU - Carr, C. A.
AU - Guimaraes, A. R.
AU - Worth, J. L.
AU - Navia, B. A.
AU - González, R. G.
PY - 1996/3
Y1 - 1996/3
N2 - The CNS is frequently involved in human immunodeficiency virus (HIV) infection. In recent studies using proton magnetic resonance spectroscopy, investigators found a significant reduction in N-acetyl aspartate, a metabolic marker of neurons, in late stages of dementia. To further understand the relationship between proton magnetic resonance spectroscopy changes and clinical disease and dementia, we compared 20 HIV-infected patients presenting at varying stages of acquired immunodeficiency syndrome (AIDS) dementia complex and infection to 10 age-matched controls. We found a significant reduction in N-acetyl aspartate/creatine only in patients who had advanced dementia and CD4 counts less than 200/μl. By contrast, a significant elevation in compounds containing choline was present in patients in the early stages of HIV infection or who had CD4 counts greater than 200/μl, in patients with normal MRI scans, and in all AIDS dementia complex groups, including subjects with no or minimal cognitive impairment. An elevated choline level also occurred in later stages of HIV infection (CD4 < 200/μl). Our results suggest that an increase in choline occurs before N- acetyl aspartate decrements, MRI abnormalities, and the onset of dementia, and may therefore provide a useful marker for early detection of brain injury associated with HIV infection.
AB - The CNS is frequently involved in human immunodeficiency virus (HIV) infection. In recent studies using proton magnetic resonance spectroscopy, investigators found a significant reduction in N-acetyl aspartate, a metabolic marker of neurons, in late stages of dementia. To further understand the relationship between proton magnetic resonance spectroscopy changes and clinical disease and dementia, we compared 20 HIV-infected patients presenting at varying stages of acquired immunodeficiency syndrome (AIDS) dementia complex and infection to 10 age-matched controls. We found a significant reduction in N-acetyl aspartate/creatine only in patients who had advanced dementia and CD4 counts less than 200/μl. By contrast, a significant elevation in compounds containing choline was present in patients in the early stages of HIV infection or who had CD4 counts greater than 200/μl, in patients with normal MRI scans, and in all AIDS dementia complex groups, including subjects with no or minimal cognitive impairment. An elevated choline level also occurred in later stages of HIV infection (CD4 < 200/μl). Our results suggest that an increase in choline occurs before N- acetyl aspartate decrements, MRI abnormalities, and the onset of dementia, and may therefore provide a useful marker for early detection of brain injury associated with HIV infection.
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U2 - 10.1212/WNL.46.3.783
DO - 10.1212/WNL.46.3.783
M3 - Article
C2 - 8618683
AN - SCOPUS:0029877220
SN - 0028-3878
VL - 46
SP - 783
EP - 788
JO - Neurology
JF - Neurology
IS - 3
ER -