Altered neurometabolite development in HIV-infected children: correlation with neuropsychological tests.
Background: HIV-infected children have abnormal cerebral metabolites, measured by proton MR spectroscopy ((1)H-MRS), but how these abnormalities relate to brain function is unclear.Methods: Metabolite concentrations in five brain regions of 20 HIV-infected and 13 control children were measured, and...
| Publicado en: | Neurology Vol. 62; no. 10; pp. 1810 - 1818 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | research Journal Article |
| Publicado: |
Lippincott Williams & Wilkins
2004 May 25
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=136640863&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 136640863 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00283878 NRO jtl: Neurology issn: 00283878 maglogo: N pubinfo: dt: 2004 May 25 vid: 62 iid: 10 pid: 433 pub: Lippincott Williams & Wilkins place: Baltimore, Maryland artinfo: ui: 136640863 136640863 NLM15159483 136640863 10.1212/01.wnl.0000125492.57419.25 NLM15159483 136640863 ppf: 1810 ppct: 8 formats: tig: atl: Altered neurometabolite development in HIV-infected children: correlation with neuropsychological tests. aug: au: Keller, M A Venkatraman, T N Thomas, A Deveikis, A LoPresti, C Hayes, J Berman, N Walot, I Padilla, S Johnston-Jones, J Ernst, T Chang, L affil: Harbor-UCLA Research and Education Institute, Torrance, CA, USA sug: subj: Biochemical Phenomena Aspartic Acid Analogs and Derivatives HIV Infections Metabolism HIV Infections Psychosocial Factors Age Factors Adolescence Viral Load CD4 Lymphocyte Count HIV Infections Pathology Magnetic Resonance Imaging Brain Metabolism Neuropsychological Tests Female Brain Pathology HIV Infections Magnetic Resonance Spectroscopy Human Male Inositol Analysis Child Aspartic Acid Analysis HIV-1 Protons Creatine Analysis Prospective Studies Choline Analysis Validation Studies Comparative Studies Evaluation Research Multicenter Studies Scales Adolescent: 13-18 years Child: 6-12 years Female Male ab: Background: HIV-infected children have abnormal cerebral metabolites, measured by proton MR spectroscopy ((1)H-MRS), but how these abnormalities relate to brain function is unclear.Methods: Metabolite concentrations in five brain regions of 20 HIV-infected and 13 control children were measured, and these findings were correlated with age, log(10) plasma viral load, CD4 count, and neuropsychological scores.Results: Compared with control subjects, HIV patients had decreased choline concentration [Cho] in left frontal white matter (LFW) (-12%; p = 0.04); those with high viral load (>5,000 HIV RNA copies/mL) had decreased right basal ganglia (RBG) [Cho] (-15%; p = 0.005), and [Cr] (-13%; p = 0.02). Patients with high viral load also had higher [Cho] in the midfrontal gray matter (MFG) (+25%; p = 0.002) and lower myo-inositol [Ins] in the RBG (-18%; p = 0.04) than patients with low HIV viral load. N-Acetyl aspartate concentration ([NAA]) correlated with age in right frontal white matter (RFW) (r = 0.59, p = 0.04), LFW (r = 0.66, p = 0.02), and right hippocampus (RHIP) (r = 0.69, p = 0.02) only in control subjects. In contrast, [Ins] correlated with age in both RFW and LFW (r = 0.71, p = 0.0006; r = 0.65, p = 0.006) only in the HIV patients. Log(10) plasma viral load correlated positively with [Ins] in RFW (r = 0.54, p = 0.02) and [Cho] in MFG (r = 0.49, p = 0.04). Compared with control subjects, HIV patients had poorer spatial memory (p = 0.045) and delayed spatial memory correlated with [Cho] in RHIP (r = 0.68, p = 0.02).Conclusions: These data suggest that normal brain development may be affected in children infected with HIV at birth, particularly evidenced by the lack of age-related increases in the neuronal marker [NAA]. Early, aggressive treatment of infants with HIV before development of encephalopathy is warranted. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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