Cognitive performance and regional brain volume in human immunodeficiency virus type 1 infection
K. Kieburtz, L. Ketonen, C. Cox, H. Grossman, R. Holloway, H. Booth, C. Hickey, A. Feigin and E. D. Caine
Department of Neurology, University of Rochester (NY) Medical Center, USA.
BACKGROUND: Brain atrophy has been reported to occur in advancing human
immunodeficiency virus (HIV) infection, particularly in patients with
HIV-related dementia. Atrophy of the caudate region, as assessed by
magnetic resonance imaging measures, has been reported to correlate with
cognitive impairment in patients with HIV infection; however, differences
in the severity of HIV-induced immunosuppression may have contributed to
these findings. OBJECTIVE: To determine the relationship between regional
brain volumes and cognitive performance in individuals with HIV infection.
PATIENTS AND METHODS: We evaluated 11 patients with advanced HIV disease by
using neuropsychologic tests and quantitative magnetic resonance imaging
volume analysis. SETTING: University hospital, involving patients from a
clinical trial. RESULTS: Caudate volume, expressed as a ratio of total
intracranial volume, correlated with performance on the Trails A and
Grooved Pegboard tests, but not with other tests of memory, motor speed, or
mood (adjusted for age and education). Hippocampal volume did not correlate
with any of the neuropsychologic tests. CONCLUSIONS: Caudate volume in
patients with advanced HIV disease is associated with poor performance on
neuropsychologic tests of complex motor and sequencing skills. Hippocampal
volume does not appear to be related to impairment on neuropsychologic
tests. These findings are independent of the degree of immunosuppression
and the overall extent of brain atrophy; however, these results must be
interpreted with some caution, given the limited sample size.