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Abnormal brain activation on functional MRI in cognitively asymptomatic HIV patients
1Medical Department, Brookhaven National Laboratory, Upton, NY 11973, USA. TErnst@bnl.gov
Background/Objectives:
A previous fMRI study demonstrated increased brain activation during working memory tasks in patients with HIV with mild dementia. The current study aims to determine whether patients who are HIV-1 positive and have normal cognitive function also show increased brain activation on fMRI.
Methods:
Blood oxygenation level-dependent (BOLD) fMRI was performed in 10 patients with HIV (CD <500) and 10 age-, sex-, education-, and handedness-matched seronegative subjects. Each subject performed a battery of neuropsychological tests and fMRI with three tasks (0-back, 1-back, and 2-back) that required different levels of attention for working memory.
Results:
Compared with control subjects, patients with HIV showed greater magnitude of brain activation (BOLD signal intensity changes, p
Conclusion:
Increased brain activation in subjects who are positive for HIV precedes clinical signs or deficits on cognitive tests. Early injury to the neural substrate may necessitate increased usage of brain reserve to maintain normal cognitive function. BOLD fMRI appears to be more sensitive than clinical and neuropsychological evaluations for detecting early HIV-associated brain injury.