Relationships among brain metabolites, cognitive function, and viral loads in antiretroviral-naive HIV patients
Relationships among brain metabolites, cognitive function, and viral loads in antiretroviral-naive HIV patients
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DOI：
10.1006/nimg.2002.1254
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发表时间：
2002-11-01
期刊：
影响因子：
5.7
通讯作者：
Miller, E
中科院分区：
文献类型：
--
作者：
Chang, L;Ernst, T;Miller, E
本研究旨在确定未经抗逆转录病毒药物治疗的HIV患者的脑代谢物浓度（质子磁共振波谱或H-1 MRS）、认知功能和临床变量（CD 4、血浆和CSF病毒载量和脂质）之间的关系。我们假设可能的神经胶质标记物肌醇（MI）和胆碱化合物（CHO）与认知功能、CD 4计数和病毒载量相关，但与血脂无关。45抗逆转录病毒药物初治的HIV患者和25名对照受试者进行了评价。额叶[MI]、[CHO]和总肌酸[CR]升高，而基底节[CR]降低，痴呆严重程度增加。作为一个群体，HIV患者表现出精细运动（凹槽钉板）和心理功能（轨迹A和B）的减慢，以及执行功能（Stroop任务）的缺陷。较低的CD 4计数和升高的血浆病毒载量与升高的额叶白色物质[MI]相关，这反过来又与Stroop任务相关。这些发现表明，全身因素（由免疫功能抑制和血浆病毒载量较高引起）可能导致额叶白色物质中的神经胶质增生（[MI]、[CHO]和[CR]升高），这反过来可能导致HIV执行功能缺陷。研究抗逆转录病毒初治患者，最大限度地减少了抗逆转录病毒治疗对临床，MRS和神经心理学变量的混杂效应，并允许更准确地评估这些测量之间的关系。应测量代谢物浓度，而不是代谢物比率，因为[CR]（代谢物比率的常用参考）随额叶和基底神经节疾病严重程度而变化。(C)2002 Elsevier Science（美国）。
This study aims to determine the relationship among cerebral metabolite concentrations (on proton magnetic resonance spectroscopy or H-1 MRS), cognitive function, and clinical variables (CD4, plasma and CSF viral loads, and lipids) in antiretroviral medication-naive HIV patients. We hypothesized that the probable glial markers myo-inositol [MI] and choline compounds [CHO] would correlate with cognitive function, CD4 count, and viral loads, but not with serum lipids. Forty-five antiretroviral-drug-naive HIV patients and 25 control subjects were evaluated. Frontal lobe [MI], [CHO], and total creatine [CR] were elevated, while basal ganglia [CR] were decreased, with increasing dementia severity. As a group, HIV patients showed slowing on fine motor (Grooved Pegboard) and psychomotor function (Trails A & B), and deficits on executive function (Stroop tasks). Lower CD4 counts and elevated plasma viral loads were associated with elevated frontal white matter [MI], which in turn correlated with the Stroop tasks. These findings suggest that systemic factors (resulting from suppressed immune function and higher plasma viral load) may lead to glial proliferation (elevated [MI], [CHO], and [CR]) in the frontal white matter, which in turn may contribute to deficits on executive function in HIV. Studying antiretroviral-naive patients minimized the confounding effects of antiretroviral treatment on the clinical, MRS, and neuropsychological variables, and allowed for a more accurate assessment of the relationships among these measurements. Metabolite concentrations, rather than metabolite ratios, should be measured since [CR], a commonly used reference for metabolite ratios, varies with disease severity in both frontal lobe and basal ganglia. (C) 2002 Elsevier Science (USA).