IN VIVO 1HMRS STUDIES OF CEREBRAL INJURY IN HIV DEMENTIA

这是一项雄心勃勃的3年多中心研究提案， 涉及至少12个站点。 使用体内1H-MRS，该联盟将 探索与CNS细胞损伤的各种模式相关的假设 在HIV感染者中。 目的是：1）量化 HIV感染者脑内NAA、Cho、MI的局部水平 定义的ADC受试者队列; 2）与相关的区域 测量细胞代谢物与神经认知功能障碍的严重程度 3）检查与全身性疾病的关系， 神经毒性、1H-MRS结果和神经心理学测试;以及4） 为了确定美金刚对这些含量的影响， 性能 该联合会将研究：（1）80例轻度或 中度痴呆，参加了一项随机双盲对照研究， 美金刚胺ACT基线和第16周试验; 2）40例血清阳性 CD 4计数小于200的神经学上无症状的受试者， （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波STEAM序列获得 皮质、半卵圆额叶中心和基底神经节。 这些区域的金属含量将以比率和 绝对测量值并与ADC的严重程度相关， 全身性疾病、替代标志物和病毒的CSF/外周研究 负荷和对美金刚胺和背景抗逆转录病毒药物的应答 疗法

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.