Caudate blood flow and volume are reduced in HIV+ neurocognitively impaired patients
Caudate blood flow and volume are reduced in HIV+ neurocognitively impaired patients
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DOI：
10.1212/01.wnl.0000203524.57993.e2
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发表时间：
2006-03-28
期刊：
影响因子：
9.9
通讯作者：
Detre, JA
中科院分区：
文献类型：
--
作者：
Ances, BM;Roc, AC;Detre, JA
目的：评价艾滋病毒相关神经认知障碍对尾状核血流量和血容量的影响。研究方法：作者对42例接受高效抗逆转录病毒治疗的HIV+患者（23例亚综合征和19例HIV神经症状性患者）和17例血清阴性对照进行了连续动脉自旋标记MRI。他们比较了各组之间尾状核的血流量和体积。结果：随着HIV相关神经认知功能障碍的增加，尾状核血流量和体积逐步减少。与血清阴性对照组相比，HIV+神经症状性患者的基线尾状核血流量减少（p = 0.001），亚综合征HIV+患者的下降趋势相似（p = 0.070）。与对照组相比，仅在神经症状性HIV+患者中观察到尾状核体积的差异（p = 0.010）。对于三个亚组中的每一个，尾状核血流量和体积的趋势的Jonckheere-Terpstra检验是显著的。各组尾状核血流量与容积的Pearson积矩相关系数均不显著。结论：尾状核血流量和血容量的下降趋势与HIV相关神经认知障碍（HNCI）的显著增加相关，在受损更严重的患者中观察到最大的下降。然而，尾状核血流量和体积的减少相关性很差。残余尾状核血流量的变化可以作为HNCI程度分类的替代生物标志物。
Objective: To evaluate the effects of HIV-associated neurocognitive impairment on caudate blood flow and volume. Methods: The authors performed continuous arterial spin labeled MRI on 42 HIV+ patients (23 subsyndromic and 19 HIV neurosymptomatic) on highly active antiretroviral therapy and 17 seronegative controls. They compared caudate blood flow and volume among groups. Results: A stepwise decrease in both caudate blood flow and volume was observed with increasing HIV-associated neurocognitive impairment. Compared with seronegative controls, baseline caudate blood flow was reduced in HIV+ neurosymptomatic patients (p = 0.001) with a similar decreasing trend for subsyndromic HIV+ patients (p = 0.070). Differences in caudate volume were observed only for neurosymptomatic HIV+ patients compared with controls (p = 0.010). A Jonckheere-Terpstra test for trends was significant for both caudate blood flow and volume for each of the three subgroups. Pearson product moment correlation coefficients were not significant between caudate blood flow and volume for each group. Conclusions: Decreasing trends in caudate blood flow and volume were associated with significantly increasing HIV-associated neurocognitive impairment (HNCI), with the greatest decreases observed for more severely impaired patients. However, reductions in caudate blood flow and volume were poorly correlated. Changes in residual caudate blood flow may act as a surrogate biomarker for classifying the degree of HNCI.