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HIV-1-associated cognitive/motor complex

Absence of neuronal loss in the cerebral neocortex

Laboratoire de Neuropathologie R. Escourolle (Drs. Seilhean, Duyckaerts, and Hauw), INSERM U 360, Association Claude Bernard, Hôpital de la Salpêtrière; the Unité d'Oncologie Vizale (Dr. Vazeux), Institut Pasteur; and the Clinique Neurologique (Drs. Bolgert and Brunet), and Département de Médecine Tropicale (Drs. Katlama and Gentilini), Parasitologie et Santé Publique, Hôpital de la Salpêtrière, Paris, France.

We performed a postmortem morphometric study in six AIDS patients and six controls to determine if a neocortical neuronal loss occurs in HIV-1-associated cognitive/motor complex. Patients were selected during a prospective study including psychometric evaluation and neuroimaging, and none had focal lesions. Two had HIV-1-associated myelopathy with mild cognitive impairment, and four had HIV-1-associated dementia complex. Planimetry did not show any cerebral atrophy. Cortical thickness, mean neuronal size, and mean neuronal densities in Brodmann's areas 4, 9, and 40 were not statistically different in patients and controls. There were no significant changes in neuronal densities of columnar and laminar samples, indicating that there was neither global nor selective neuronal loss. HIV-1-associated cognitive/motor complex is not necessarily related to neocortical neuronal loss, but could be due to subcortical lesions or metabolic dysfunction.

Address correspondence and reprint requests to Dr. Danielle Seilhean, Laboratoire R. Escourolle, Hôpital de la Salpêtrière, 47 Bd de l'Hôpital, 75651 Paris Cedex 13, France.

Received August 27, 1992. Accepted for publication in final form December 22, 1992.

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