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Basal ganglia metabolite abnormalities in minor motor disorders associated with human immunodeficiency virus type 1
H J von Giesen1, H J Wittsack, F Wenserski
1Department of Neurology, Heinrich-Heine-Universität, Düsseldorf, Postfach 10 10 07, D-40001 Düsseldorf, Germany. giesenhj@uni-duesseldorf.de
Background:
Minor motor disorders (MMDs) associated with human immunodeficiency virus type 1 (HIV-1) predict HIV-1 dementia and death. Little is known about the time course and neuropathologic mechanisms of HIV-1 MMDs.
Objective:
To investigate the relationship between HIV-1 MMDs, as assessed by psychomotor speed, and metabolic alterations in the basal ganglia, as detected by proton magnetic resonance spectroscopy.
Patients And Methods:
A total of 32 HIV-1-seropositive patients (10 with no MMD, 8 with incipient MMD, and 14 with sustained MMD, assessed through electrophysiologic testing of psychomotor speed including contraction times; 29 treated with highly active antiretroviral therapy) and 14 HIV-1-seronegative control subjects were examined for cerebral metabolite abnormalities in the basal ganglia by means of magnetic resonance spectroscopy.
Results:
The 3 patient groups showed significantly different ratios of myoinositol/creatine (P =.02) in the basal ganglia. Whereas patients with no MMD or incipient MMD showed normal ratios, patients with sustained MMD showed higher values for myoinositol/creatine as a sign of glial proliferation. No differences in N-acetyl compounds, indicative of neuronal loss, were found.
Conclusion:
Whereas metabolic alterations in the basal ganglia were not detected in patients with incipient HIV-1 MMD, patients with sustained HIV-1 MMD did have significantly altered metabolic spectra indicative of glial proliferation.
Insights
Minor motor disorders (MMDs) in human immunodeficiency virus type 1 (HIV-1) are linked to brain changes. Sustained MMDs show glial proliferation in the basal ganglia, unlike incipient MMDs.
Area of Science:
- Neuroscience
- Neurology
- Medical Imaging
Background:
- Minor motor disorders (MMDs) in human immunodeficiency virus type 1 (HIV-1) infection are indicators of potential HIV-1 dementia and mortality.
- The temporal progression and underlying neuropathological mechanisms of HIV-1 MMDs remain largely uncharacterized.
Purpose of the Study:
- To examine the correlation between minor motor disorders (MMDs) in HIV-1 patients, evaluated via psychomotor speed, and metabolic changes within the basal ganglia.
- To utilize proton magnetic resonance spectroscopy (MRS) to detect these metabolic alterations.
Main Methods:
- Magnetic resonance spectroscopy (MRS) was employed to assess cerebral metabolite abnormalities in the basal ganglia of 32 HIV-1-seropositive patients and 14 HIV-1-seronegative controls.
- Patients were categorized into three groups: no MMD, incipient MMD, and sustained MMD, based on electrophysiologic testing of psychomotor speed.
Main Results:
- Significant differences in the myoinositol/creatine ratio were observed in the basal ganglia across the three patient groups (P =.02).
- Patients with sustained MMD exhibited elevated myoinositol/creatine ratios, suggesting glial proliferation.
- No significant differences in N-acetyl compounds, which indicate neuronal loss, were found among the groups.
Conclusions:
- Metabolic alterations in the basal ganglia were not evident in HIV-1 patients with incipient MMD.
- Sustained MMD in HIV-1 patients was associated with significantly altered metabolic spectra indicative of glial proliferation.