Thinning of the cerebral cortex visualized in HIV/AIDS reflects CD4+ T lymphocyte decline
Thinning of the cerebral cortex visualized in HIV/AIDS reflects CD4+ T lymphocyte decline
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DOI：
10.1073/pnas.0502548102
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发表时间：
2005-10-25
影响因子：
11.1
通讯作者：
Becker, JT
中科院分区：
文献类型：
--
作者：
Thompson, PM;Dutton, RA;Becker, JT
艾滋病毒/艾滋病感染是全世界第四大死亡原因，每100名15至49岁的成年人中就有一人感染艾滋病毒。40%的艾滋病患者患有神经系统症状，但艾滋病毒在大脑中造成的选择性损害尚未得到很好的了解。在这里，我们报告了揭示艾滋病如何影响人类大脑皮层的3D地图，确定了最脆弱的区域，以及与认知能力下降和免疫系统抑制有关的缺陷。通过高分辨率的脑MRI扫描，我们绘制了26名艾滋病患者和14名健康对照者的皮质灰质厚度复合图，以建立艾滋病患者脑缺陷的选择性模式。在艾滋病患者中，初级感觉、运动和前运动皮层变薄了15%。通过血液中CD4(+) T淋巴细胞水平测量，额极和语言皮层变薄与免疫系统恶化相关。前额叶和顶叶组织损失与认知/运动缺陷相关。因此，T细胞耗损和认知障碍与MRI显示的特定3D脑缺陷模式有关。这些基于核磁共振成像的定量图谱揭示了艾滋病毒选择性地损害了大脑皮层。他们提供了一种方法来衡量艾滋病对活体大脑的影响，并表明即使患者接受抗逆转录病毒治疗，大脑仍然容易受到感染。
HIV/AIDS infection is the fourth leading cause of death worldwide, and one in every 100 adults aged 15-49 years is HIV-infected. Forty percent of AIDS patients suffer from neurological symptoms, but the selective profile of damage caused by HIV in the brain is not well understood. Here, we report 3D maps revealing how AIDS affects the human cerebral cortex, identifying the most vulnerable regions and where deficits link with cognitive decline and immune-system suppression. With high-resolution brain MRI scans, we created composite maps of cortical gray-matter thickness in 26 AIDS patients and 14 healthy controls to establish the selective pattern of brain deficits in AIDS. In AIDS, primary sensory, motor, and premotor cortices were 15% thinner. Thinner frontopolar and language cortex correlated with immune system deterioration measured through blood levels of CD4(+) T lymphocytes. Prefrontal and parietal tissue loss correlated with cognitive/motor deficits. T cell depletion and cognitive impairment are, therefore, associated with specific 3D brain-deficit patterns visualized with MRI. These quantitative MRI-based maps reveal that HIV selectively damages the cortex. They provide an approach to gauge the impact of AIDS on the living brain and show that the brain is still vulnerable to infection even when patients are receiving antiretroviral therapy.