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Perfusion MRI detects rCBF abnormalities in early stages of HIV-cognitive motor complex
L Chang1, T Ernst, M Leonido-Yee
1Department of Neurology, Harbor-UCLA Medical Center, Torrance, CA 90502, USA.
Objective:
To evaluate patients with early HIV-cognitive motor complex (HIV-CMC) for possible regional cerebral blood flow (rCBF) abnormalities on perfusion MRI (pMRI).
Background:
Nuclear medicine techniques have demonstrated global and focal cerebral perfusion abnormalities in patients with HIV dementia. Ultrafast pMRI enables the measurement of rCBF throughout the brain without the need to apply radioactive tracers or ionizing radiation.
Methods:
pMRI was used to measure the rCBF in 19 patients with early stages of HIV-CMC and 15 healthy seronegative control subjects. The rCBF maps were registered to high-resolution anatomic MRI scans and transformed into Talairach space. Statistical analysis of the rCBF maps was performed with SPM96.
Results:
Compared with the control subjects, the patients with HIV had statistically significantly decreased rCBF bilaterally in the inferior lateral frontal cortices (right: -15%, p < 0.002; left: -12%, p < 0.005) and in the inferior medial parietal brain region (-15%, p < 0.0009). In contrast, rCBF was increased bilaterally in the posterior inferior parietal white matter (right: +19%, p < 0.0001; left: + 17%, p < 0.001). Furthermore, rCBF abnormalities correlated significantly with clinical disease severity as measured by CD4 count, plasma viral load, Karnofsky score, and HIV dementia scale.
Discussion:
Our results are consistent with previous findings from PET and SPECT studies. Furthermore, pMRI can detect rCBF abnormalities that correlate with disease severity in HIV-CMC. Because pMRI is more cost-effective, faster, and safer than nuclear medicine techniques for monitoring rCBF changes, pMRI may be more feasible for monitoring the effects of therapy for HIV-CMC.
Insights
Perfusion MRI (pMRI) detected regional cerebral blood flow (rCBF) abnormalities in early HIV-cognitive motor complex (HIV-CMC). These findings correlate with disease severity, suggesting pMRI as a feasible monitoring tool.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Nuclear medicine studies show cerebral perfusion abnormalities in HIV dementia.
- Ultrafast perfusion MRI (pMRI) measures regional cerebral blood flow (rCBF) non-invasively.
Purpose of the Study:
- Evaluate early HIV-cognitive motor complex (HIV-CMC) for rCBF abnormalities using pMRI.
- Compare rCBF in HIV-CMC patients and healthy controls.
Main Methods:
- pMRI was used to measure rCBF in 19 HIV-CMC patients and 15 controls.
- rCBF maps were analyzed using statistical parametric mapping (SPM96).
Main Results:
- HIV-CMC patients showed decreased rCBF in frontal and parietal cortices.
- Increased rCBF was observed in parietal white matter.
- rCBF abnormalities correlated with CD4 count, viral load, and clinical scores.
Conclusions:
- pMRI detects rCBF abnormalities in early HIV-CMC, consistent with prior nuclear medicine studies.
- pMRI findings correlate with disease severity.
- pMRI offers a cost-effective, faster, and safer alternative for monitoring HIV-CMC progression and therapy effects.