Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Data Supplement
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Keller, M. A.
Right arrow Articles by Chang, L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Keller, M. A.
Right arrow Articles by Chang, L.
Related Collections
Right arrow MRS
Right arrow HIV
Right arrow All Pediatric
Right arrow HIV dementia
NEUROLOGY 2004;62:1810-1817
© 2004 American Academy of Neurology

Altered neurometabolite development in HIV-infected children

Correlation with neuropsychological tests

M. A. Keller, MD, T. N. Venkatraman, PhD, A. Thomas, PhD, A. Deveikis, MD, C. LoPresti, PhD, J. Hayes, RN, N. Berman, PhD, I. Walot, MD, S. Padilla, PsyD, J. Johnston-Jones, PhD, T. Ernst, PhD and L. Chang, MD

From the Harbor–UCLA Research and Education Institute (Drs. Keller, Venkatraman, Berman, Walot, Padilla, and Johnston–Jones, J. Hayes), Torrance, University of California, Los Angeles (Drs. Thomas and LoPresti), and Miller’s Children’s Hospital (Dr. Deveikis), Long Beach, CA; and Brookhaven National Laboratory (Drs. Ernst and Chang), Upton, NY.

Address correspondence and reprint requests to Dr. M.A. Keller, Department of Pediatrics, Harbor–UCLA Medical Center, 1000 W. Carson St., Bldg. N25, Box 468, Los Angeles, CA 90509; e-mail: keller{at}rei.edu

Background: HIV-infected children have abnormal cerebral metabolites, measured by proton MR spectroscopy (1H-MRS), but how these abnormalities relate to brain function is unclear.

Methods: Metabolite concentrations in five brain regions of 20 HIV-infected and 13 control children were measured, and these findings were correlated with age, log10 plasma viral load, CD4 count, and neuropsychological scores.

Results: Compared with control subjects, HIV patients had decreased choline concentration [Cho] in left frontal white matter (LFW) (–12%; p = 0.04); those with high viral load (>5,000 HIV RNA copies/mL) had decreased right basal ganglia (RBG) [Cho] (–15%; p = 0.005), and [Cr] (–13%; p = 0.02). Patients with high viral load also had higher [Cho] in the midfrontal gray matter (MFG) (+25%; p = 0.002) and lower myo-inositol [Ins] in the RBG (–18%; p = 0.04) than patients with low HIV viral load. N-Acetyl aspartate concentration ([NAA]) correlated with age in right frontal white matter (RFW) (r = 0.59, p = 0.04), LFW (r = 0.66, p = 0.02), and right hippocampus (RHIP) (r = 0.69, p = 0.02) only in control subjects. In contrast, [Ins] correlated with age in both RFW and LFW (r = 0.71, p = 0.0006; r = 0.65, p = 0.006) only in the HIV patients. Log10 plasma viral load correlated positively with [Ins] in RFW (r = 0.54, p = 0.02) and [Cho] in MFG (r = 0.49, p = 0.04). Compared with control subjects, HIV patients had poorer spatial memory (p = 0.045) and delayed spatial memory correlated with [Cho] in RHIP (r = 0.68, p = 0.02).

Conclusions: These data suggest that normal brain development may be affected in children infected with HIV at birth, particularly evidenced by the lack of age-related increases in the neuronal marker [NAA]. Early, aggressive treatment of infants with HIV before development of encephalopathy is warranted.

Received August 1, 2003. Accepted in final form January 13, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the May 25 issue to find the title link for this article.




This article has been cited by other articles:


Home page
 J Child NeurolHome page
L. Gabis, A. Belman, Wei Huang, M. Milazzo, and S. Nachman
Clinical and Imaging Study of Human Immunodeficiency Virus-1--Infected Youth Receiving Highly Active Antiretroviral Therapy: Pilot Study Using Magnetic Resonance Spectroscopy
J Child Neurol, June 1, 2006; 21(6): 485 - 490.
[Abstract] [PDF]

Home page
 NeurologyHome page
M. A. Keller, T. N. Venkatraman, M. A. Thomas, A. Deveikis, C. LoPresti, J. Hayes, N. Berman, I. Walot, T. Ernst, and L. Chang
Cerebral metabolites in HIV-infected children followed for 10 months with 1H-MRS
Neurology, March 28, 2006; 66(6): 874 - 879.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2004 by AAN Enterprises, Inc.