Correlation between computed tomographic brain scan abnormalities and neuropsychological function in children with symptomatic human immunodeficiency virus disease
P. Brouwers, C. DeCarli, L. Civitello, H. Moss, P. Wolters and P. Pizzo
Pediatric Branch, National Cancer Institute, Bethesda, Md.
OBJECTIVE: To evaluate the clinical significance of computed tomographic
brain scan abnormalities observed in children with symptomatic human
immunodeficiency virus disease. PATIENTS: Eighty-seven previously untreated
children with symptomatic human immunodeficiency virus type 1 disease.
METHODS: General levels of cognitive functioning, obtained from
age-appropriate intelligence tests, and social-emotional behavior were
correlated with computed tomographic brain scan abnormality ratings.
RESULTS: A significant relation between computed tomographic brain scan
abnormalities and cognitive dysfunction as well as aberrant behavior was
found, which appeared stronger in (younger) vertically infected children
compared with transfusion-infected patients. Calcifications, independent
from the degree of brain atrophy, were associated with significantly
greater delays in neurocognitive development. CONCLUSION: Computed
tomographic brain scan abnormalities, even when mild, were of clinical
significance, suggesting that human immunodeficiency virus-associated
central nervous system compromise is a continuous process and that scans
may be helpful at baseline in defining patients at risk and for monitoring
them during therapy.