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Karl Kieburtz, MD; Leena Ketonen, MD, PhD; Christopher Cox, PhD; Hillel Grossman, MD; Robert Holloway, MD; Heather Booth, MS; Charlyne Hickey, RNc; Andrew Feigin, MD; Eric D. Caine, MD

Arch Neurol. 1996;53(2):155-158.

Abstract
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.

Author Affiliations
From the Departments of Neurology (Drs Kieburtz, Holloway, and Feigin and Ms Hickey), Radiology (Dr Ketonen), Biostatistics (Dr Cox), and Psychiatry (Drs Grossman and Caine and Ms Booth), University of Rochester (NY) Medical Center.

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