Clinical and spectroscopic improvement in HIV-associated cognitive impairment
B. Stankoff, MD*;,
A. Tourbah, MD, PhD*;,
S. Suarez, PhD;,
E. Turell, MD;,
J.L. Stievenart, MD;,
C. Payan, MD, PhD;,
A. Coutellier, MD;,
S. Herson, MD;,
L. Baril, MD;,
F. Bricaire, MD;,
V. Calvez, MD, PhD;,
E.A. Cabanis, MD;,
L. Lacomblez, MD, PhD and
C. Lubetzki, MD, PhD
From the Fédération de Neurologie I (Drs. Stankoff, Tourbah, Turell, and Lubetzki), Laboratoire de Neuropathologie R. Escourolle (Dr. Suarez), Fédération de Neurologie Mazarin II (Dr. Lacomblez), and Service de Pharmacologie (Drs. Payan and Lacomblez,), Service de Médecine Interne (Drs. Coutellier and Herson); Service des Maladies Infectieuses (Drs. Baril and Bricaire), Laboratoire de Virologie CERVI (Dr. Calvez), Hôpital Pitié Salpêtrière, AP-HP and University Paris VI; and Service de Neuroradiologie (Drs. Tourbah, Stievenart, and Cabanis), Centre Hospitalier National des Quinze-Vingts, Paris, France.
Figure 1. Brain MRI showing on axial fluid-attenuated inversion recovery sequences the two volumes selected in the white matter, one in the centrum semi-ovale and the other in the frontal white matter (a) and the volume selected in the medial parieto-occipital gray matter (b). (c) Spectrum at ET = 136 ms showing the NAA and Cho peaks; (d) spectrum at ET = 18 ms showing the Myo peak; (e) spectrum at ET = 30 ms.
Figure 2. Individual neuropsychological and MRS data: longitudinal study. Mattis score (A, B) and frontal NAA/Cr (C, D) evolution in cognitively unimpaired (CU) (A, C) and impaired (B, D) patients. Normal mean (black arrow) and range (white arrowhead) of NAA/Cr. White circles correspond to the three patients with leukoencephalopathy. White triangles correspond to the single CU patient with cognitive decline. Note that he was also the only CU patient with a decrease of NAA/Cr ratio throughout follow-up.
