Patterns of cerebral atrophy in HIV–1–infected individuals

Abstract

Cerebral atrophy is a common radiologic manifestation of HIV dementia. To evaluate the relationship between cognitive impairment and cerebral atrophy, adjusting for age and immune status, we used standardized planimetry to measure the ventricle-brain ratio (VBR) and the bifrontal (BFR) and bicaudate (BCR) ratios, three measures of cerebral atrophy. We analyzed cranial MRIs of 23 HIV-1-seronegative controls (SN) and 116 HIV-1-infected individuals. Of the HIV-1-seropositive individuals, 37 had HIV dementia (DM group), 40 had neurologic or neuropsychological abnormalities insufficient for HIV dementia (NP+ group), and 39 were neurologically normal (NML group). We performed comparisons using analysis of covariance with correction for multiple comparisons. Both the VBR, a general measure of overall cerebral atrophy, and the BCR, a measure of atrophy in the region of the caudate nucleus, are significantly associated with dementia. The association is stronger for BCR enlargement than for VBR enlargement, suggesting that selective caudate region atrophy is associated with HIV dementia. These results indicate that overall cerebral atrophy and prominent caudate region atrophy are important radiographic features of HIV dementia.

Components of Depression in HIV-1 Infection: Their Differential Relationship to Neurocognitive Performance

“…The neurocognitive deficits typically associated with HIV-1 infection include decrements in motor and information-processing speed, divided attention, memory retrieval processes, and executive functioning. This pattern of cognitive deficits is consistent with the known sites of neuropathology in HIV/AIDS, which include the basal ganglia and deep white matter tracks (Aylward et al, 1993;Brew, Rosenblum, & Price, 1988;Dal Pan et al, 1992;Grant & Martin, 1994;Navia, Cho, Petito, & Price, 1986).…”

The Role of Medical Imaging in Defining CNS Abnormalities Associated with HIV-Infection and Opportunistic Infections

“…This line of investigation was initiated early in the HIV pandemic and quickly established a variety of pathological effects observable in vivo. The most common findings included regional gray matter atrophy, particularly in the basal ganglia [4][5][6], Electronic supplementary material The online version of this article (doi:10.1007/s13311-010-0010-4) contains supplementary material, which is available to authorized users. white matter lesions [7,8], ventricular expansion [9], and global cerebral atrophy [7,[10][11][12].…”

“…In particular, volumes of the basal ganglia are commonly decreased in HIV-infected patients [4-6, 13, 14] and have been shown to be associated with cognitive function [4,15] and biomarkers of HIV progression [16,17]. Specifically, atrophy of the caudate has been widely reported [6,15,18,19] and found to be associated with cognitive [5,20] and motor [21] dysfunction as well as lower CD4 T-cell counts [17].…”

Blood-Brain Barrier Disruption Is Initiated During Primary HIV Infection and Not Rapidly Altered by Antiretroviral Therapy

“…Chronic exposure to human immunodeficiency virus (HIV) can lead to neurological complications, with one third of untreated individuals with advanced AIDS developing HIV-associated dementia [1,2], a syndrome of severe cognitive, motor, and behavioral disturbances primarily associated with subcortical atrophy [3]. Although the incidence of HIV-associated dementia has significantly decreased with the advent of combination antiretroviral therapy (cART), a milder spectrum of neurocognitive deficits persists despite treatment [1,2,4].…”