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Ned Sacktor, MD; Isak Prohovnik, PhD; Ronald L. Van Heertum, MD; George Dooneief, MD, MPH; Jack Gorman, MD; Karen Marder, MD, MPH; George Todak, MSW; Yaakov Stern, PhD; Richard Mayeux, MD, MSE

Arch Neurol. 1995;52(6):607-611.

Abstract
Objective
To determine whether technetium Tc 99m exametazime single-photon computed emission tomography (SPECT) can distinguish gay human immunodeficiency virus (HIV)—positive subjects, both with and without mild cognitive impairment, from gay HIV-negative control subjects.

Design
Twenty HIV-positive subjects (12 without cognitive impairment and eight with mild cognitive impairment) and 10 HIV-negative subjects underwent neurological, neuropsychological, magnetic resonance imaging, and technetium Tc 99m exametazime SPECT examinations.

Setting
Subjects were recruited from a natural history study of gay men with HIV infection.

Patients
Subjects from the cohort who had previously participated in a magnetic resonance imaging study were selected for the SPECT study.

Main Outcome Measures
The SPECT scans were rated as abnormal if focal defects, confirmed by a horizontal profile analysis, were seen.

Results
Sixty-seven percent of HIV-positive subjects without cognitive impairment, 88% of HIV-positive subjects with mild cognitive impairment, and 20% of HIV-negative subjects had abnormal SPECT scans (P<.05 for both HIV-positive groups when each group was compared with HIV-negative subjects).

Conclusion
Compared with gay HIV-negative control subjects, focal SPECT defects are seen with an increased frequency in HIV-positive gay men without cognitive impairment and in HIV-positive gay men with mild cognitive impairment.

Author Affiliations
From the Gertrude H. Sergievsky Center (Drs Sacktor, Dooneief, Marder, Stern, and Mayeux), the HIV Center for Clinical and Behavioral Studies (Drs Sacktor, Dooneief, Gorman, Marder, Stern, and Mayeux and Mr Todak), and Division of Brain Imaging (Dr Prohovnik), New York State Psychiatric Institute, and the Departments of Neurology (Drs Sacktor, Prohovnik, Dooneief, Marder, Stern, and Mayeux), Radiology (Drs Prohovnik and Van Heertum), and Psychiatry (Drs Prohovnik, Gorman, Marder, Stern, and Mayeux and Mr Todak), Columbia University College of Surgeons and Physicians, New York, NY. Dr Sacktor is presently with the Johns Hopkins Bayview Medical Center, Baltimore, Md.

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