IN VIVO 1HMRS STUDIES OF CEREBRAL INJURY IN HIV DEMENTIA

这是一项为期3年的多中心研究的雄心勃勃的提议，将 涉及至少12个地点。使用活体1H-MRS，该联盟将 探索与中枢神经系统细胞损伤的各种模式相关的假说 在感染艾滋病毒的个人中。目标是：1)量化 井内HIV感染者脑内NAA、CHO、MI的区域性水平 已确定的具有ADC的受试者队列；2)相关区域 神经认知严重程度与细胞代谢产物的测定 损害与系统性疾病的关系；3)研究 神经毒性、1H-MRS结果和神经心理测试； 为了确定美金刚对这些成分含量的影响 性能。该联盟将研究：(1)80名轻度或轻度 中度痴呆，随机双盲对照 美金刚法案基线和第16周试验；2)40项血清阳性 CD4低于200的无神经症状受试者， (3)40例年龄匹配的血清阴性对照。质子光谱将是 使用来自顶骨的短回声蒸汽序列获得 皮质、额叶半卵圆中心和基底节。 来自这些区域的代谢物将被量化为比率和 绝对测量，并与ADC的严重程度和 全身性疾病、脑脊液/外周替代标志物和病毒研究 负担、对美金刚和背景抗逆转录病毒的反应 心理治疗。

This is an ambitious proposal for a 3 year multicenter study that will involve at least 12 sites. Using in vivo 1H-MRS, this consortium will explore hypotheses that relate various patterns of CNS cellular injury in individuals with HIV infection. The aims are: 1) To quantify regional levels of NAA, Cho, MI in the HIV-infected brain in a well defined cohort of subjects with ADC; 2) To correlated regional measurements of cellular metabolites with severity of neurocognitive impairment and systemic disease; 3) To examine the relationship of neurotoxicity, 1H-MRS results and neuropsychological testing; and 4) To determine the effects of memantine on the content of these performance. This consortium will study: (1) 80 subjects with mild or moderate dementia, enrolled in a randomized double-blind controlled trial of memantine act baseline and week 16; 2) 40 seropositive neurologically asymptomatic subjects with CD4 counts less than 200, and 3) 40 age-matched seronegative controls. Proton spectra will be obtained using a short echo STEAM sequence from the parietal cortex, the frontal centrum semiovale, and the basal ganglia. Metabolites from these regions will be quantified as ratios and absolute measurements and correlated with the severity of ADC and systemic disease, CSF/peripheral studies of surrogate markers and viral burden, and response to memantine and background antiretroviral therapy.