MOTOR ANALYSIS PREDICTS PROGRESSION IN HIV-ASSOCIATED BRAIN DISEASE
MOTOR ANALYSIS PREDICTS PROGRESSION IN HIV-ASSOCIATED BRAIN DISEASE
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DOI：
10.1016/0022-510x(94)90221-6
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发表时间：
1994-05-01
影响因子：
4.4
通讯作者：
FREUND, HJ
中科院分区：
文献类型：
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作者：
ARENDT, G;HEFTER, H;FREUND, HJ
100名无临床明显中枢神经系统（CNS）缺陷的HIV阳性个体进入本随访研究，并在2年内每3个月进行一次临床检查和明确的运动测试组合，或直至死亡。他们每年接受一次磁共振断层扫描。在研究开始时，没有人接受任何形式的治疗。分析了三组：研究开始后，（A）无电生理学可检测到的运动损伤的患者（n = 23），（B）有电生理学可检测到的运动损伤但无病毒抑制药物的患者（n = 33），和（C）接受AZT治疗的运动缺陷患者（n = 44）。A组患者，虽然随着时间的推移略有恶化，但与其他组相比，具有最好的临床和电生理结果，而B组患者在临床和电生理测试中明显恶化，即使大多数在观察期间没有发生脑并发症。属于早期CDC阶段（II和III）的C组患者在AZT治疗下电生理学改善，而76%的晚期（CDC IVA-D）患者死于脑AIDS表现。这一组中有4名患者在研究结束时还活着，但已完全痴呆。这表明，早期检测到的运动障碍预测未来的大脑参与艾滋病。晚期病毒抑制治疗不影响临床结果。
One hundred HIV-positive individuals without clinically evident central nervous system (CNS) deficits entered this follow-up study and were examined clinically and with a well-defined motor test battery every 3 months over 2 years or until they deceased. They underwent magnetic resonance tomography once a year. None received any form of therapy at onset of the study. Three groups were analyzed: (A) patients without electrophysiologically detectable motor impairment (n = 23), (B) patients with electrophysiologically detectable motor impairment but no virostatic medication (n = 33), and (C) patients with motor deficits undergoing AZT treatment (n = 44) after study onset. Group A patients, although slightly deteriorating over time, had the best clinical and electrophysiological outcome compared to the other groups, whereas group B patients deteriorated markedly in both clinical and electrophysiological tests, even though the majority did not develop cerebral complications during the observation period. Those group C patients belonging to early CDC stages (II and III) improved electrophysiologically under AZT therapy, while 76% of the patients in more advanced stages (CDC IVA-D) died of cerebral AIDS manifestations. Four patients of this group, being alive at the end of the study, were completely demented. It is suggested that early detectable motor impairment predicts future cerebral involvement in AIDS. Late onset of virostatic treatment did not influence the clinical outcome.