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European Radiology
Published in: European Radiology 10/2017

01-10-2017 | Neuro

HIV-associated neurodegeneration and neuroimmunity: multivoxel MR spectroscopy study in drug-naïve and treated patients

Authors: Jasmina Boban, Dusko Kozic, Vesna Turkulov, Jelena Ostojic, Robert Semnic, Dajana Lendak, Snezana Brkic

Published in: European Radiology | Issue 10/2017

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Abstract

Objectives

The aim of this study was to test neurobiochemical changes in normal appearing brain tissue in HIV+ patients receiving and not receiving combined antiretroviral therapy (cART) and healthy controls, using multivoxel MR spectroscopy (mvMRS).

Methods

We performed long- and short-echo 3D mvMRS in 110 neuroasymptomatic subjects (32 HIV+ subjects on cART, 28 HIV+ therapy-naïve subjects and 50 healthy controls) on a 3T MR scanner, targeting frontal and parietal supracallosal subcortical and deep white matter and cingulate gyrus (NAA/Cr, Cho/Cr and mI/Cr ratios were analysed). The statistical value was set at p < 0.05.

Results

Considering differences between HIV-infected and healthy subjects, there was a significant decrease in the NAA/Cr ratio in HIV+ subjects in all observed locations, an increase in mI/Cr levels in the anterior cingulate gyrus (ACG), and no significant differences in Cho/Cr ratios, except in ACG, where the increase showed trending towards significance in HIV+ patients. There were no significant differences between HIV+ patients on and without cART in all three ratios.

Conclusion

Neuronal loss and dysfunction affects the whole brain volume in HIV-infected patients. Unfortunately, cART appears to be ineffective in halting accelerated neurodegenerative process induced by HIV but is partially effective in preventing glial proliferation.

Key Points

• This is the first multivoxel human brain 3T MRS study in HIV.
• All observed areas of the brain are affected by neurodegenerative process.
• Cingulate gyrus and subcortical white matter are most vulnerable to HIV-induced neurodegeneration.
• cART is effective in control of inflammation but ineffective in preventing neurodegeneration.
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Metadata
Title
HIV-associated neurodegeneration and neuroimmunity: multivoxel MR spectroscopy study in drug-naïve and treated patients
Authors
Jasmina Boban
Dusko Kozic
Vesna Turkulov
Jelena Ostojic
Robert Semnic
Dajana Lendak
Snezana Brkic
Publication date
01-10-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 10/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-4772-5

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