• Bmc Neurol · Jan 2012

    Comparative Study

    Early microstructural white matter changes in patients with HIV: a diffusion tensor imaging study.

    • Bianca Stubbe-Drger, Michael Deppe, Siawoosh Mohammadi, Simon S Keller, Harald Kugel, Nora Gregor, Stefan Evers, Peter Young, E-Bernd Ringelstein, Gabriele Arendt, Stefan Knecht, Ingo W Husstedt, and German Competence Network HIV/AIDS.
    • Department of Neurology, University of M uumlnster, Albert-Schweitzer-Campus, Germany. dragerb@uni-muenster.de
    • Bmc Neurol. 2012 Jan 1;12:23.

    BackgroundPrevious studies have reported white matter (WM) brain alterations in asymptomatic patients with human immunodeficiency virus (HIV).MethodsWe compared diffusion tensor imaging (DTI) derived WM fractional anisotropy (FA) between HIV-patients with and without mild macroscopic brain lesions determined using standard magnetic resonance imaging (MRI). We furthermore investigated whether WM alterations co-occurred with neurocognitive deficits and depression. We performed structural MRI and DTI for 19 patients and 19 age-matched healthy controls. Regionally-specific WM integrity was investigated using voxel-based statistics of whole-brain FA maps and region-of-interest analysis. Each patient underwent laboratory and neuropsychological tests.ResultsStructural MRI revealed no lesions in twelve (HIV-MRN) and unspecific mild macrostructural lesions in seven patients (HIV-MRL). Both analyses revealed widespread FA-alterations in all patients. Patients with HIV-MRL had FA-alterations primarily adjacent to the observed lesions and, whilst reduced in extent, patients with HIV-MRN also exhibited FA-alterations in similar regions. Patients with evidence of depression showed FA-increase in the ventral tegmental area, pallidum and nucleus accumbens in both hemispheres, and patients with evidence of HIV-associated neurocognitive disorder showed widespread FA-reduction.ConclusionThese results show that patients with HIV-MRN have evidence of FA-alterations in similar regions that are lesioned in HIV-MRL patients, suggesting common neuropathological processes. Furthermore, they suggest a biological rather than a reactive origin of depression in HIV-patients.

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