This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (62)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • HIV/AIDS  • Radiologic Imaging  • Magnetic Resonance Imaging  • Alert me on articles by topic  Social Bookmarking   What's this?

A Longitudinal Volumetric Magnetic Resonance Imaging Study

Julie C. Stout, PhD; Ronald J. Ellis, MD, PhD; Terry L. Jernigan, PhD; Sarah L. Archibald, MA; Ian Abramson, PhD; Tanya Wolfson; J. Allen McCutchan, MD; Mark R. Wallace, MD; J. Hampton Atkinson, MD; Igor Grant, MD; and the HIV Neurobehavioral Research Center Group

Arch Neurol. 1998;55:161-168.

Objective  To compare rates and anatomical patterns of brain atrophy during 3 stages of human immunodeficiency virus (HIV) disease.

Design  Comparisons of multiple serial brain magnetic resonance images in men without HIV infection and HIV-infected men in Centers for Disease Control and Prevention (CDC, Atlanta, Ga) stages A, B, and C.

Setting  Longitudinal cohort study of the San Diego HIV Neurobehavioral Research Center, San Diego, Calif.

Participants  Eighty-six HIV-1–positive (HIV-positive) and 23 HIV-negative men who were similar in age and risk group. The number of HIV-positive men in each CDC stage was as follows: A, 33; B, 19; C, 34. All HIV-positive men were free of clinically detectable opportunistic neurologic illness.

Main Outcome Measures  Regional volumes of serial magnetic resonance images converted to standardized slope estimates of change in regional volumes of interest.

Results  Medically asymptomatic men (CDC stage A) and medically symptomatic men (CDC stage C) had more rapid loss of cortical tissues than did HIV-negative men as manifested by higher slopes (Tukey honestly significant difference test, P=.02 and P=.001, respectively) for cortical fluid volume. Accelerated ventricular volume enlargement occurred only in men with CDC stage C disease. Reduction in the volume of white matter was accelerated in participants with CDC stage C disease compared with participants with CDC stage A disease. Of the gray matter regions, only the caudate nucleus sustained accelerated volume loss during CDC stage C disease. Participants whose systemic disease progressed to a higher CDC stage had significantly accelerated ventricular volume increases and caudate atrophy. Rates of cortical and subcortical fluid volume increases and reductions in the volumes of white matter and the caudate nucleus were significantly related to the rate of decline in the CD4⁺ lymphocyte count.

Conclusions  In the absence of cerebral opportunistic disease, HIV infection causes progressive atrophy within the gray and white matter in the brain. These changes were most severe in the most advanced stage of disease but were evident even in medically asymptomatic HIV-positive persons. Within the gray matter, the caudate nucleus exhibited progressive volume loss linked to disease stage and the rate of decline of the CD4⁺cell count. Structural brain changes can begin in the early stages of HIV infection and accelerate during advanced illness.

From the Departments of Psychiatry (Drs Stout, Jernigan, Atkinson, and Grant and Mss Archibald and Wolfson), Neurosciences (Dr Ellis), Mathematics (Dr Abramson), and Medicine (Dr McCutchan), University of California, San Diego; the Department of Veterans Affairs Medical Center, San Diego, Calif (Drs Jernigan, Atkinson, and Grant); and the US Naval Medical Center, San Diego, Calif (Dr Wallace). Dr Stout is now with the Department of Psychology, Indiana University, Bloomington.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Putamen Hypertrophy in Nondemented Patients With Human Immunodeficiency Virus Infection and Cognitive Compromise
Castelo et al.
Arch Neurol 2007;64:1275-1280.
ABSTRACT | FULL TEXT  

Diffusion tensor imaging with quantitative fibre tracking in HIV infection and alcoholism comorbidity: synergistic white matter damage
Pfefferbaum et al.
Brain 2007;130:48-64.
ABSTRACT | FULL TEXT  

Thinning of the cerebral cortex visualized in HIV/AIDS reflects CD4+ T lymphocyte decline
Thompson et al.
Proc. Natl. Acad. Sci. USA 2005;102:15647-15652.
ABSTRACT | FULL TEXT  

Effects of Methamphetamine Dependence and HIV Infection on Cerebral Morphology
Jernigan et al.
Am. J. Psychiatry 2005;162:1461-1472.
ABSTRACT | FULL TEXT  

HIV leucoencephalopathy and TNF{alpha} expression in neurones
Rostasy et al.
J. Neurol. Neurosurg. Psychiatry 2005;76:960-964.
ABSTRACT | FULL TEXT  

Correlation of In Vivo Neuroimaging Abnormalities With Postmortem Human Immunodeficiency Virus Encephalitis and Dendritic Loss
Archibald et al.
Arch Neurol 2004;61:369-376.
ABSTRACT | FULL TEXT  

Whole Brain Imaging of HIV-Infected Patients: Quantitative Analysis of Magnetization Transfer Ratio Histogram and Fractional Brain Volume
Ge et al.
Am. J. Neuroradiol. 2003;24:82-87.
ABSTRACT | FULL TEXT  

Risk Factors for Cognitive Impairment in HIV-1-Infected Persons With Different Risk Behaviors
De Ronchi et al.
Arch Neurol 2002;59:812-818.
ABSTRACT | FULL TEXT  

Correlation between Percentage of Brain Parenchymal Volume and Neurocognitive Performance in HIV-Infected Patients
Patel et al.
Am. J. Neuroradiol. 2002;23:543-549.
ABSTRACT | FULL TEXT  

Elevated cerebrospinal fluid quinolinic acid levels are associated with region-specific cerebral volume loss in HIV infection
Heyes et al.
Brain 2001;124:1033-1042.
ABSTRACT | FULL TEXT