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AIDS and its Related Infections

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MR Imaging and Spectroscopy of Central Nervous System Infection

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Abstract

Human immunodeficiency virus (HIV)-infected individuals often suffer from central nervous system (CNS) damage. Ten percent have a CNS lesion as the first clinical manifestation of AIDS while 40% suffer a neurologic complication at some point. Approximately 80% of those examined on autopsy show CNS abnormalities (1-5). In the CNS, HIV infection predominantly results in opportunistic infections, lymphoma, and neuropsychiatric disorders. Other sources of morbidity and mortality are vascular, toxic, metabolic, and autoimmune phenomena. Neuroimaging plays a key role in diagnosis and guiding therapy.

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References

  1. Navia BA, Jordan BD, Price RW. The AIDS dementia complex: I. Clinical features. Ann Neurol 1986; 19:517–524.

    Article  CAS  PubMed  Google Scholar 

  2. Navia BA, Cho ES, Petito CK, Price RW. The AIDS dementia complex: II. Neuropathology. Ann Neurol 1986; 19:525–535.

    Article  CAS  PubMed  Google Scholar 

  3. Price RW, Brew B, Sidtis J, Rosenblum M, Scheck AC, Geary P. The brain in AIDS: Central nervous system HIV-1 infection and AIDS dementia complex. Science 1988; 239:586–592.

    Article  CAS  PubMed  Google Scholar 

  4. Fischer PA, Enzensberger W. Primary and secondary involvement of the CNS in HIV infection. J Neuroimmunol 1988; 20:127–131.

    Article  CAS  PubMed  Google Scholar 

  5. Post MJ. Neuroimaging in various stages of human immunodeficiency virus infection. Curr Opin Radiol 1990; 2:73–79.

    CAS  PubMed  Google Scholar 

  6. Aronow HA, Brew BJ, Price RW. The management of the neurological complications of HIV infection and AIDS. AIDS 1988; 2:S151–159.

    Article  Google Scholar 

  7. Nomenclature and research case definitions for neurologic manifestations of human immunodeficiency virustype 1 (HIV-1) infection. Report of a Working Group of the American Academy of Neurology AIDS Task Force [see comments]. Neurology 1991; 41:778-785.

    Google Scholar 

  8. Post MJ, Sheldon JJ, Hensley GT, et al. Central nervous system disease in acquired immunodeficiency syndrome: Prospective correlation using CT, MR imaging, and pathologic studies. Radiology 1986; 158:141–148.

    CAS  PubMed  Google Scholar 

  9. Trotot PM, Gray F. Diagnostic imaging contribution in the early stages of HIV infection of the brain. Neuroimaging Clin North Am 1997; 7:243–260.

    CAS  Google Scholar 

  10. Tracey I, Hamberg LM, Guimaraes AR, et al. Increased cerebral blood volume in HIV-positive patients detected by functional MRI. Neurology 1998; 50:1821–1826.

    Article  CAS  PubMed  Google Scholar 

  11. Achim CL, Wang R, Miners DK, Wiley CA. Brain viral burden in HIV infection. J Neuropathol Exp Neurol 1994; 53:284–294.

    Article  CAS  PubMed  Google Scholar 

  12. Masliah E, Ge N, Achim CL, Wiley CA. Differential vulnerability of calbindin-immunoreactive neurons in HIV encephalitis. J Neuropathol Exp Neurol 1995; 54:350–357.

    Article  CAS  PubMed  Google Scholar 

  13. Chang L, Speck O, Leonido-Yee M, Ernst T. Cerebral perfusion abnormalities in patients with HIV. 51st Meeting of the American Academy of Neurology, Toronto, 1999.

    Google Scholar 

  14. Jarvik JG, Lenkinski RE, Grossman RI, Gomori JM, Schnall MD, Frank I. Proton MR spectroscopy of HIV-infected patients: Characterization of abnormalities with imaging and clinical correlation. Radiology 1993; 186:739–744.

    CAS  PubMed  Google Scholar 

  15. Barker PB, Lee RR, McArthur JC. AIDS dementia complex: Evaluation with proton MR sþectroscopic imaging. Radiology 1995; 195:58–64.

    CAS  PubMed  Google Scholar 

  16. Lu D, Pavlakis SG, Frank Y, et al. Proton MR spectroscopy of the basal ganglia in healthy children and children with AIDS. Radiology 1996; 199:423–428.

    CAS  PubMed  Google Scholar 

  17. Möller HE, Vermathen P, Lentschig MG, et al. Metabolic characterization of AIDS dementia complex by spectroscopic imaging. J Magn Reson Imaging 1999; 9:10–18.

    Article  PubMed  Google Scholar 

  18. Salvan AM, Vion-Dury J, Confort-Gouny S, Nicoli F, Lamoureux S, Cozzone PJ. Brain proton magnetic resonance spectroscopy in HIV-related encephalopathy: Identification of evolving metabolic patterns in relation to dementia and therapy. AIDS Res Hum Retroviruses 1997; 13:1055–1066.

    Article  CAS  PubMed  Google Scholar 

  19. Salvan AM, Lamoureux S, Michel G, Confort-Gouny S, Cozzone PJ, Vion-Dury J. Localized proton magnetic resonance spectroscopy of the brain in children infected with human immunodeficiency virus with and without encephalopathy. Pediatr Res 1998; 44:755–762.

    Article  CAS  PubMed  Google Scholar 

  20. Salvan AM, Vion-Dury J, Confort-Gouny S, Nicoli F, Lamoureux S, Cozzone PJ. Cerebral metabolic alterations in human immunodeficiency virus-related encephalopathy detected by proton magnetic resonance spectroscopy. Comparison between sequences using short and long echo times. Invest Radiol 1997; 32:485–495.

    Article  CAS  PubMed  Google Scholar 

  21. Tracey I, Carr CA, Guimaraes AR, Worth JL, Navia BA, Gonzalez KG. Brain choline-containing compounds are elevated in HIV-positive patients before the onset of AIDS dementia complex: A proton magnetic resonance spectroscopic study [published erratum appears in Neurology 1996; 46(6): 1787]. Neurology 1996; 46:783–788.

    Article  CAS  PubMed  Google Scholar 

  22. Vion-Dury J, Confort-Gouny S, Nicoli F, et al. Localized brain proton MRS metabolic patterns in HIV-related encephalopathies. C R Acad Sci III 1994; 317:833–840.

    CAS  Google Scholar 

  23. Vion-Dury J, Nicoli F, Salvan AM, Confort-Gouny S, Dhiver C, Cozzone PJ. Reversal of brain metabolic alterations with zidovudine detected by proton localised magnetic resonance spectroscopy [letter]. Lancet 1995; 345:60–61.

    Article  CAS  PubMed  Google Scholar 

  24. Wilkinson ID, Lunn S, Miszkiel KA, et al. Proton MRS and quantitative MRI assessment of the short term neurological response to antiretroviral therapy in AIDS. J Neurol Neurosurg Psychiatry 1997; 63:477–482.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  25. Chang L. Reversal of cerebral metabolite abnormalities with highly active antiretroviral therapy (HAART) in mild HIV-1 dementia. ISMRM, 7th Scientific Meeting. Philadelphia.

    Google Scholar 

  26. Rand SD, Prost R, Li SJ. Proton MR spectroscopy of the brain. Neuroimaging Clin North Am 1999; 9:379–395.

    CAS  Google Scholar 

  27. Chang L, Ernst T, Leonido-Yee M, Walot I, Singer E. Cerebral metabolite abnormalities correlate with clinical severity of HIV-1 cognitive motor complex. Neurology 1999; 52:100–108.

    Article  CAS  PubMed  Google Scholar 

  28. Urenjak J, Williams SR, Gadian DG, Noble M. Proton nuclear magnetic resonance spectroscopy in vitro. J Neurochem 1992; 59:55–61.

    Article  CAS  PubMed  Google Scholar 

  29. Urenjak J, Williams SR, Gadian DG, Noble M. Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci 1993; 13:981–989.

    CAS  PubMed  Google Scholar 

  30. Chong WK, Sweeney B, Wilkinson ID, et al. Proton spectroscopy of the brain in HIV infection: Correlation with clinical, immunologic, and MR imaging findings. Radiology 1993; 188:119–124.

    CAS  PubMed  Google Scholar 

  31. Chong WK, Paley M, Wilkinson ID, et al. Localized cerebral proton MR spectroscopy in HIV infection and AIDS. Am J Neuroradiol 1994,15:21–25.

    CAS  PubMed  Google Scholar 

  32. Gouny S, Vion-Dury J, Nicoli F, et al. A multiparametric data analysis showing the potential of localized proton MR spectroscopy of the brain in the metabolic characterization of neurological diseases. J Neurol Sci 1993; 118:123–133.

    Article  Google Scholar 

  33. Cortey A, Jarvik JG, Lenkinski RE, Grossman RI, Frank I, Delivoria-Papadopoulos M. Proton MR spectroscopy of brain abnormalities in neonates born to HIV positive mothers. Am J Neuroradiol 1994; 15:1853–1859.

    CAS  PubMed  Google Scholar 

  34. Jarvik JG, Lenkinski RE, Saykin AJ, Jaans A, Frank I. Proton spectroscopy in asymptomatic HIV-infected adults: Initial results in a prospective cohort study. J Acquir Immune Defic Syndr Hum Retrovirol 1996; 13:247–253.

    Article  CAS  PubMed  Google Scholar 

  35. Laubenberger J, Haussinger D, Bayer S, et al. HIV-related metabolic abnormalities in the brain: Depiction with proton MR spectroscopy with short echo times. Radiology 1996; 199:805–810.

    CAS  PubMed  Google Scholar 

  36. Lopez-Villegas D, Lenkinski RE, Frank I. Biochemical changes in the frontal lobe of HIV-infected individuals detected by magnetic resonance spectroscopy. Proc Natl Acad Sci USA 1997; 94:9854–9859.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  37. McConnell JR, Swindells S, Ong CS, et al. Prospective utility of cerebral proton magnetic resonance spectroscopy in monitoring HIV infection and its associated neurological impairment. AIDS Res Hum Retroviruses 1994; 10:977–982.

    Article  CAS  PubMed  Google Scholar 

  38. Menon DK, Ainsworth JG, Cox IJ, et al. Proton MR spectroscopy of the brain in AIDS dementia complex. J Comput Assist Tomogr 1992; 16:538–542.

    Article  CAS  PubMed  Google Scholar 

  39. MeyerhofF DJ, MacKay S, Bachman L, et al. Reduced brain N-acetylaspartate suggests neuronal loss in cognitively impaired human immunodeficiency virus-seropositive individuals: In vivo 1H magnetic resonance spectroscopic imaging. Neurology 1993; 43:509–515.

    Article  CAS  PubMed  Google Scholar 

  40. Meyerhoff DJ, MacKay S, Poole N, Dillon WP, Weiner MW, Fein G. N-acetylaspartate reductions measured by 1H MRSI in cognitively impaired HIV-seropositive individuals. Magn Reson Imaging 1994; 12:653–659.

    Article  CAS  PubMed  Google Scholar 

  41. Meyerhoff DJ, Bloomer C, Cardenas V, Norman D, Weiner MW, Fein G. Elevated subcortical choline metabolites in cognitively and clinically asymptomatic HIV+ patients. Neurology 1999; 52:995–1003.

    Article  CAS  PubMed  Google Scholar 

  42. Paley M, Wilkinson ID, Hall-Craggs MA, Chong WK, Chinn RJ, Harrison MJ. Short echo time proton spectroscopy of the brain in HIV infection/AIDS. Magn Reson Imaging 1995; 13:871–875.

    Article  CAS  PubMed  Google Scholar 

  43. Pavlakis SG, Lu D, Frank Y, et al. Magnetic resonance spectroscopy in childhood AIDS encephalopathy. Pediatr Neurol 1995; 12:277–282.

    Article  CAS  PubMed  Google Scholar 

  44. Wilkinson ID, Paley M, Chong WK, et al. Proton spectroscopy in HIV infection: Relaxation times of cerebral metabolites. Magn Reson Imaging 1994; 12:951–957.

    Article  CAS  PubMed  Google Scholar 

  45. Wilkinson ID, Miller RF, Miszkiel KA, et al. Cerebral proton magnetic resonance spectroscopy in asymptomatic HIV infection. AIDS 1997; 11:289–295.

    Article  CAS  PubMed  Google Scholar 

  46. Miller BL, Chang L, Booth R, et al. In vivo 1H MRS choline: Correlation with in vitro chemistry/histology. Life Sci 1996; 58:1929–1935.

    Article  CAS  PubMed  Google Scholar 

  47. Confort-Gouny S, Vion-Dury J, Nicoli F, Dano P, Gastaut JL, Cozzone PJ. Metabolic characterization of neurological diseases by proton localized NMR spectroscopy of the human brain. C R Acad Sci III 1992; 315:287–293.

    CAS  Google Scholar 

  48. Paley M, Cozzone PJ, Alonso J, et al. A multicenter proton magnetic resonance spectroscopy study of neurological complications of AIDS. AIDS Res Hum Retroviruses 1996; 12:213–222.

    Article  CAS  PubMed  Google Scholar 

  49. Vion-Dury J, Salvan AM, Confort-Gouny S, Cozzone PJ. Brain proton magnetic resonance spectroscopy. Indications for diagnosis and follow-up of HIV-related encephalopathy in the adult. Presse Med 1998; 27:1398–1405.

    CAS  PubMed  Google Scholar 

  50. Brand A, Richter-Landsberg C, Leibfritz D. Multinuclear NMR studies on the energy metabolism of glial and neuronal cells. DevNeurosci 1993; 15:289–298.

    CAS  Google Scholar 

  51. Newsholme P, Gordon S, Newsholme EA. Rates of utilization and fates of glucose, glutamine, pyruvate, fatty acids and ketone bodies by mouse macrophages. Biochem J 1987; 242:631–636.

    CAS  PubMed Central  PubMed  Google Scholar 

  52. Newsholme P, Newsholme EA. Rates of utilization of glucose, glutamine and oleate and formation of end-products by mouse peritoneal macrophages in culture. Biochem J 1989; 261:2l 1–218.

    CAS  PubMed Central  PubMed  Google Scholar 

  53. Petroff OA, Graham GD, Blamire AM, et al. Spectroscopic imaging of stroke in humans: Histopathology correlates of spectral changes. Neurology 1992; 42:1349–1354.

    Article  CAS  PubMed  Google Scholar 

  54. Graham GD, Blamire AM, Rothman DL, et al. Early temporal variation of cerebral metabolites after human stroke. A proton magnetic resonance spectroscopy study. Stroke 1993; 24:1891–1896.

    Article  CAS  PubMed  Google Scholar 

  55. Menon DK, Baudouin CJ, Tomlinson D, Hoyle C. Proton MR spectroscopy and imaging of the brain in AIDS: Evidence of neuronal loss in regions that appear normal with imaging. J Comput Assist Tomogr 1990; 14:882–885.

    Article  CAS  PubMed  Google Scholar 

  56. Eng LF, Ghirnikar RS. GFAP and astrogliosis. Brain Pathol 1994; 4:229–237.

    Article  CAS  PubMed  Google Scholar 

  57. Everall IP, Heaton RK, Marcotte TD, et al. Cortical synaptic density is reduced in mild to moderate human immunodeficiency virus neurocognitive disorder. HNRC Group. HIV Neurobehavioral Research Center. Brain Pathol 1999; 9:209–217.

    Article  CAS  PubMed  Google Scholar 

  58. Gray F, Scaravilli F, Everall I, et al. Neuropathology of early HIV-1 infection. Brain Pathol 1996; 6:1–15.

    Article  CAS  PubMed  Google Scholar 

  59. Gonzalez RG, Ruiz A, Tracey I, McConnell J. Structural, functional, and molecular neuroimaging in AIDS. In The neurology of AIDS ,HE Gendelman, SA Lipton, L Epstein, S Swindells, eds. London: Edwin Arnold, 1998;333–352.

    Google Scholar 

  60. Harrison MJ, Newman SP, Hall-Craggs MA, et al. Evidence of CNS impairment in HIV infection: Clinical, neuropsychological, EEG, and MRI/MRS study. J Neurol Neurosurg Psychiatry 1998; 65:301–307.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  61. Wilkinson ID, Miller RF, Paley MN, et al. Cerebral proton magnetic resonance spectroscopy in cytomegalovirus encephalitis and HIV leucoencephalopathy/encephalitis [letter]. AIDS 1996; 10:1443–1444.

    Article  CAS  PubMed  Google Scholar 

  62. Deicken RF, Hubesch B, Jensen PC, et al. Alterations in brain phosphate metabolite concentrations in patients with human immunodeficiency virus infection. Arch Neurol 1991; 48:203–209.

    Article  CAS  PubMed  Google Scholar 

  63. Bottomley PA, Hardy CJ, Cousins JP, Armstrong M, Wagle WA. AIDS dementia complex: Brain high energy phosphate metabolite deficits. Radiology 1990; 176:407–411.

    CAS  PubMed  Google Scholar 

  64. Cohen WA. Intracranial bacterial infections in patients with AIDS. Neuroimaging Clin North Am 1997; 7:223–229.

    CAS  Google Scholar 

  65. Ramsey RG, Gean AD. Neuroimaging of AIDS. I. Central nervous system toxoplasmosis. Neuroimaging Clin North Am 1997; 7:171–186.

    CAS  Google Scholar 

  66. Lizerbram EK, Hesselink JR. Neuroimaging of AIDS. I. Viral infections. Neuroimaging Clin North Am 1997; 7:261–280.

    CAS  Google Scholar 

  67. Harris DE, Enterline DS. Neuroimaging of AIDS. I. Fungal infections of the central nervous system. Neuroimaging Clin North Am 1997; 7:187–198.

    CAS  Google Scholar 

  68. Whiteman ML. Neuroimaging of central nervous system tuberculosis in HIV-infected patients. Neuroimaging Clin North Am 1997; 7:199–214.

    CAS  Google Scholar 

  69. Harris DE, Enterline DS, Tien RD. Neurosyphilis in patients with AIDS. Neuroimaging Clin North Am 1997; 7:215–221.

    CAS  Google Scholar 

  70. Chang L, Miller BL, McBride D, et al. Brain lesions in patients with AIDS: H-1 MR spectroscopy [published erratum appears in Radiology 1996; 198: 586]. Radiology 1995; 197:525–531.

    CAS  PubMed  Google Scholar 

  71. Chinn RJ, Wilkinson ID, Hall-Craggs MA, et al. Toxoplasmosis and primary central nervous system lymphoma in HIV infection: Diagnosis with MR spectroscopy. Radiology 1995; 197:649–654.

    CAS  PubMed  Google Scholar 

  72. Ernst TM, Chang L, Witt MD, et al. Cerebral toxoplasmosis and lymphoma in AIDS: Perfusion MR imaging experience in 13 patients. Radiology 1998; 208:663–669.

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. MGH-NMR Center, Charlestown, Massachusetts, 02129, USA

    K. E. Sakaie & Robert G. Gonzalez

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  1. K. E. Sakaie
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  2. Robert G. Gonzalez
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Editors and Affiliations

  1. Department of Radiodiagnosis, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, 226014, India

    Rakesh K. Gupta M.D. (Additional Professor) (Additional Professor)

  2. Department of Radiological Sciences, University of California, Los Angeles Medical Center, Los Angeles, California, 90095, USA

    Robert B. Lufkin M.D. (Professor) (Professor)

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© 2001 Kluwer Academic / Plenum Publishers

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Sakaie, K.E., Gonzalez, R.G. (2001). AIDS and its Related Infections. In: Gupta, R.K., Lufkin, R.B. (eds) MR Imaging and Spectroscopy of Central Nervous System Infection. Springer, Boston, MA. https://doi.org/10.1007/0-306-46844-1_7

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  • DOI: https://doi.org/10.1007/0-306-46844-1_7

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4757-0573-7

  • Online ISBN: 978-0-306-46844-5

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