Magnetoencephalography as a Biomarker for HIV-Associated Neurocognitive Disorder

描述(由申请人提供)：在获得良好医疗保健的国家，艾滋病毒疾病正在成为一种更严重的慢性病。在神经艾滋病领域，没有公认的、有用的生物标记物来诊断与艾滋病毒疾病相关的认知障碍(即艾滋病毒相关的神经认知障碍(HAND))，独立于认知测试。磁共振成像和正电子发射断层扫描已经尝试过，但还没有实现它们的承诺{Price，2007#6509}。我们的研究小组最近才将一项新兴技术应用于艾滋病毒疾病，这就是脑磁图(MEG)。脑磁图是一种通过记录同步神经元电流产生的磁场来测量神经元活动的非侵入性技术。脑磁图具有目前所有神经成像技术中最高的空间和时间分辨率，最常用于癫痫患者的临床评估，并被认知神经科学家用于研究中枢神经系统的电生理反应。与功能核磁共振等技术不同，脑磁图不依赖于血氧水平依赖的反应来产生反应。因此，确定脑磁图是否能识别HIV疾病中的脑功能异常将是非常重要的--特别是当认知功能障碍较轻且尚未影响日常生活活动时。 我们的团队已经证明，我们可以区分感染和未感染的研究对象，可能存在一种独立的脑磁图衍生变量，该变量对认知功能障碍敏感，并且脑磁图信号在6个月期间是稳定的。初步研究是在R03资助的研究背景下进行的，因此这项新的R21研究项目的总体目标是从30名感染者(和10名对照)获得必要的额外数据，以最终完成更大规模的纵向研究的设计。这些数据将使我们能够开始使用一种高度敏感的电生理工具来表征艾滋病毒疾病的神经认知结果。

DESCRIPTION (provided by applicant): HIV disease is becoming more of a chronic condition in countries with good access to medical care. In the area of NeuroAIDS there is no acknowledged, useful biomarker for the cognitive disorder associated with HIV disease (i.e., HIV-Associated Neurocognitive Disorder (HAND)), independent of the cognitive tests. Magnetic resonance imaging and positron emission tomography have been tried, but have yet to fulfill their promise {Price, 2007 #6509}. One emerging technology that has only recently been applied to HIV Disease - by our research team - is magnetoencephalography (MEG). MEG is a non-invasive technique for measuring neuronal activity by recording the magnetic fields induced by synchronized neuronal currents. MEG has the highest spatial and temporal resolution of any current neuroimaging technology, and is used most commonly in the clinical evaluation of patients with seizure disorders, and by cognitive neuroscientists to investigate electrophysiological responses of the CNS. Unlike techniques such as functional MRI, MEG does not rely on the blood-oxygen level dependent response in order to generate responses. Thus, it will be very important to determine whether MEG can identify abnormal brain function in HIV Disease - especially when cognitive dysfunction is mild and not yet affecting activities of daily living. Our team has demonstrated that we can differentiate infected from uninfected study subjects, that there may be an independent MEG-derived variable that is sensitive to cognitive dysfunction, and that MEG signals are stable over a 6-month period. The preliminary research was conducted in the context of an R03-funded study, so the overall goal of this new R21 research project is to obtain the necessary additional data from 30 infected individuals (and 10 controls) to finalize the design for a larger, longitudinal study. These data will allow us to begi to characterize the neurocognitive outcomes of HIV Disease using a highly sensitive electrophysiological tool.