Role of neuroimaging in HIV-associated neurocognitive disorders.
Role of neuroimaging in HIV-associated neurocognitive disorders.
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DOI：
10.1055/s-0034-1372346
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发表时间：
2014-02
影响因子：
2.7
通讯作者：
Ances BM
中科院分区：
文献类型：
--
作者：
Masters MC;Ances BM
艾滋病毒在血清转换后不久进入大脑，可导致艾滋病毒相关的神经认知障碍(手)。虽然由于联合抗逆转录病毒治疗(CART)，较严重和进行性的手部形式较少流行，但约40%的艾滋病毒感染(HIV+)患者仍有认知障碍。一些使用CART有效抑制血浆HIV-1RNA的HIV+个体仍然会发生手部疾病。在门诊环境中诊断手部疾病通常很困难，因为需要进行详细的神经心理表现测试。评估HIV相关的神经病理变化需要更多相对容易获得和临床相关的生物标记物。近年来发展起来的非侵入性磁共振成像(MRI)技术具有作为生物标志物的巨大潜力。我们回顾了一些神经成像技术[磁共振波谱(MRS)、体积磁共振成像(MRI)、扩散张量成像(DTI)、功能磁共振成像(FMRI)]在HIV阳性个体中的应用。每种神经成像方法都为神经艾滋病毒的潜在机制提供了独特的见解，可以监测疾病的进展，并可能有助于评估特定CART方案的疗效。人们希望继续取得相当大的进展，以便这些神经成像方法中的一些将被纳入多个地点并包括在未来的手指南中。
HIV enters the brain soon after seroconversion and can cause HIV associated neurocognitive disorders (HAND). While the more severe and progressive forms of HAND are less prevalent due to combination antiretroviral therapy (cART), ~ 40% of HIV-infected (HIV+) patients continue to have cognitive impairment. Some HIV+ individuals who have effective plasma HIV-1 RNA suppression with cART still develop HAND. It is often difficult to diagnose HAND in the outpatient setting as detailed neuropsychological performance testing is required. Additional biomarkers that are relatively easy to obtain and clinically relevant are needed for assessing HIV associated neuropathologic changes. Recently developed non-invasive magnetic resonance imaging (MRI) techniques have great potential to serve as biomarkers. We review the application of some of these neuroimaging techniques [magnetic resonance spectroscopy (MRS), volumetric MRI, diffusion tensor imaging (DTI), functional MRI (fMRI)] in HIV+ individuals. Each of the neuroimaging methods offers unique insight into mechanisms underlying neuroHIV, could monitor disease progression, and may assist in evaluating the efficacy of particular cART regimens. It is hoped that considerable progress will continue to occur such that some of these neuroimaging methods will be incorporated across multiple sites and included in future HAND guidelines.
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