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BMC Neurology
Published in: BMC Neurology 1/2016

Open Access 01-12-2016 | Research article

Case control study: magnetic resonance spectroscopy of brain in HIV infected patients

Authors: Devender Bairwa, Virendra Kumar, Surabhi Vyas, Bimal Kumar Das, Achal Kumar Srivastava, Ravinder M. Pandey, Surendra K. Sharma, Naranamangalam R. Jagannathan, Sanjeev Sinha

Published in: BMC Neurology | Issue 1/2016

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Abstract

Background

In vivo proton magnetic resonance spectroscopy (1H-MRS) studies on brain in HIV infected patients have shown significant alteration in neuro-biochemicals.

Methods

In this study, we measured the neuro-biochemical metabolites from the left frontal white matter (FWM) and left basal ganglia (BG) caudate head nucleus in 71 subjects that include 30 healthy controls, 20 asymptomatic HIV and 21 HIV patients with CNS lesion. Proton MR spectra were acquired at 3 T MRI system and the concentration (institutional units) of tNAA (N-acetylaspartate, NAA + N-acetylaspartylglutamate, NAAG), tCr (Creatine, Cr + phosphocreatine, PCr), choline containing compounds (tCho), glutamate + glutamine (Glx) and lipid and macromolecules at 0.9 ppm were determined using LC Model.

Results

In BG, the concentration of tNAA (6.71 ± 0.64) was decreased and in FWM, the concentration of Glx (20.4 ± 7.8), tCr (9.14 ± 3.04) and lipid and macromolecules at 0.9 ppm (8.69 ± 2.96) were increased in HIV patients with CNS lesion. In healthy controls, the concentration of tNAA in BG was 7.31 ± 0.47 and concentration of Glx, tCr and lipid and macromolecules in FWM were 15.0 ± 6.06, 6.95 ± 2.56, 5.59 ± 1.56, respectively.

Conclusion

Reduced tNAA in BG suggests neuronal loss in HIV patients with CNS lesion while increased Glx in FWM may suggest excito-toxicity. In addition, increased levels of tCr in FWM of HIV patients were observed. The study indicates region specific metabolic changes in tNAA, tCr and Glx in brain of HIV infected patients.
Literature
1.
2.
3.
Grant I, Atkinson JH, Hesselink JR, Kennedy CJ, Richman DD, Spector SA, McCutchan JA. Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections: Studies with neuropsychologic testing and magnetic resonance imaging. Ann Intern Med. 1987;107(6):828–36.CrossRefPubMed
4.
Fauci AS, Lane HC. HIV neurology. In Hauser SI and Josephson (Eds.), Harrison’s neurology in clinical medicine (2nd ed.). New York: McGraw-Hill; 2010.
5.
Chong W, Sweeney B, Wilkinson I, Paley M, Hall-Craggs M, Kendall B, Shepard J, Beecham M, Miller R, Weller I. Proton spectroscopy of the brain in HIV infection: correlation with clinical, immunologic, and MR imaging findings. Radiology. 1993;188(1):119–24.CrossRefPubMed
6.
Laubenberger J, Häussinger D, Bayer S, Thielemann S, Schneider B, Mundinger A, Hennig J, Langer M. HIV-related metabolic abnormalities in the brain: depiction with proton MR spectroscopy with short echo times. Radiology. 1996;199(3):805–10.CrossRefPubMed
7.
Suwanwelaa N, Phanuphak P, Phanthumchinda K, Suwanwela NC, Tantivatana J, Ruxrungtham K, Suttipan J, Wangsuphachart S, Hanvanich M. Magnetic resonance spectroscopy of the brain in neurologically asymptomatic HIV-infected patients. Magn Reson Imaging. 2000;18(7):859–65.CrossRefPubMed
8.
Tarasow E, Wiercińska‐Drapało A, Kubas B, Dzienis W, Orzechowska‐Bobkiewicz A, Prokopowicz D, Walecki J. Cerebral MR spectroscopy in neurologically asymptomatic HIV‐infected patients. Acta Radiol. 2003;44(2):206–12.
9.
Ferrarese C, Aliprandi A, Tremolizzo L, Stanzani L, De Micheli A, Dolara A, Frattola L. Increased glutamate in CSF and plasma of patients with HIV dementia. Neurology. 2001;57(4):671–5.CrossRefPubMed
10.
Bezzi P, Domercq M, Brambilla L, Galli R, Schols D, De Clercq E, Vescovi A, Bagetta G, Kollias G, Meldolesi J, et al. CXCR4-activated astrocyte glutamate release via TNFalpha: amplification by microglia triggers neurotoxicity. Nat Neurosci. 2001;4(7):702–10.CrossRefPubMed
11.
Kumar BR, Dudala SR, Rao A. Kuppuswamy’s socio-economic status scale–a revision of economic parameter for 2012. Int J Res Dev Health. 2013;1(1):2–4.
12.
Provencher SW. Automatic quantitation of localized in vivo1H spectra with LCModel. NMR Biomed. 2001;14(4):260–4.CrossRefPubMed
13.
Aronow HA, Brew BJ, Price RW. The management of the neurological complications of HIV infection and AIDS. AIDS. 1988;2:S151–160.CrossRefPubMed
14.
Post M, Berger J, Duncan R, Quencer R, Pall L, Winfield D. Asymptomatic and neurologically symptomatic HIV-seropositive subjects: results of long-term MR imaging and clinical follow-up. Radiology. 1993;188(3):727–33.CrossRefPubMed
15.
Dellinger RP, Levy MM, Carlet JM, Bion J, Parker MM, Jaeschke R, Reinhart K, Angus DC, Brun-Buisson C, Beale R. Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock: 2008. Intensive Care Med. 2008;34(1):17–60.CrossRefPubMed
16.
Ledergerber B, Egger M, Erard V, Weber R, Hirschel B, Furrer H, Battegay M, Vernazza P, Bernasconi E, Opravil M. AIDS-related opportunistic illnesses occurring after initiation of potent antiretroviral therapy: the Swiss HIV Cohort Study. JAMA. 1999;282(23):2220–6.CrossRefPubMed
17.
Moore RD, Chaisson RE. Natural history of opportunistic disease in an HIV-infected urban clinical cohort. Ann Intern Med. 1996;124(7):633–42.CrossRefPubMed
18.
Agarwal D, Chakravarty J, Sundar S, Gupta V, Bhatia B. Correlation between clinical features and degree of immunosuppression in HIV infected children. Indian Pediatr. 2008;45(2):140.PubMed
19.
Belperio PS, Rhew DC. Prevalence and outcomes of anemia in individuals with human immunodeficiency virus: a systematic review of the literature. Am J Med. 2004;116(7):27–43.CrossRef
20.
Maciejewski JP, Weichold FF, Young NS. HIV-1 suppression of hematopoiesis in vitro mediated by envelope glycoprotein and TNF-alpha. J Immunol. 1994;153(9):4303–10.PubMed
21.
Spivak JL, Barnes DC, Fuchs E, Quinn TC. Serum immunoreactive erythropoietin in HIV-infected patients. JAMA. 1989;261(21):3104–7.CrossRefPubMed
22.
Desforges JF, Horsburgh Jr CR. Mycobacterium avium complex infection in the acquired immunodeficiency syndrome. N Engl J Med. 1991;324(19):1332–8.CrossRef
23.
Faulds D, Heel RC. Ganciclovir: A review of its antiviral activity,pharmacokinetic properties and therapeutic efficiency in cytomegalovirus infections. Drugs 1990;39(4):597-638.
24.
Keisu M, Wiholm B, Palmblad J. Trimethoprim-sulphamethoxazole-associated blood dyscrasias. Ten years’ experience of the Swedish spontaneous reporting system. J Intern Med. 1990;228(4):353–60.CrossRefPubMed
25.
Morfeldt-månson L, Böttiger B, Nilsson B, Stedingk L-V. Clinical signs and laboratory markers in predicting progression to AIDS in HIV-1 infected patients. Scand J Infect Dis. 1991;23(4):443–9.CrossRefPubMed
26.
Glassock RJ, Cohen AH, Danovitch G, Parsa KP. Human immunodeficiency virus (HIV) infection and the kidney. Ann Intern Med 1990;112:35-49.
27.
Vitting KE, Gardenswartz MH, Zabetakis PM, Tapper ML, Gleim GW, Agrawal M, Michelis MF. Frequency of hyponatremia and nonosmolar vasopressin release in the acquired immunodeficiency syndrome. JAMA. 1990;263(7):973–8.CrossRefPubMed
28.
29.
Velazquez H, Perazella MA, Wright FS, Ellison DH. Renal mechanism of trimethoprim-induced hyperkalemia. Ann Intern Med. 1993;119(4):296–301.CrossRefPubMed
30.
Ross AC, Taylor CL, Yaktine AL, Del Valle HB, eds. Dietary reference intakes for calcium and vitamin D. National Academies Press; 2011.
31.
Emejulu A, Onwuliri V, Ojiako O. Electrolyte Abnormalities and Renal Impairment in Asymptomatic HIV-infected Patients in Owerri, South Eastern Nigeria. Aust J Basic Appl Sci. 2011;5(3):257–60.
32.
Strauss KW. Endocrine complications of the acquired immunodeficiency syndrome. Arch Intern Med. 1991;151(7):1441–4.CrossRefPubMed
33.
34.
Zilberberg MD, Exuzides A, Spalding J, Foreman A, Jones AG, Colby C, Shorr AF. Hyponatremia and hospital outcomes among patients with pneumonia: a retrospective cohort study. BMC Pulm Med. 2008;8(1):16.CrossRefPubMedPubMedCentral
35.
Tang WW, Kaptein EM, Feinstein EI, Massry SG. Hyponatremia in hospitalized patients with the acquired immunodeficiency syndrome (AIDS) and the AIDS-related complex. Am J Med. 1993;94(2):169–74.CrossRefPubMed
36.
Uno K, Konishi M, Yoshimoto E, Kasahara K, Mori K, Maeda K, Ishida E, Konishi N, Murakawa K, Mikasa K. Fatal cytomegalovirus-associated adrenal insufficiency in an AIDS patient receiving corticosteroid therapy. Intern Med. 2007;46(9):617–20.CrossRefPubMed
37.
Berggren R, Batuman V. HIV-associated renal disorders: recent insights into pathogenesis and treatment. Curr HIV/AIDS Rep. 2005;2(3):109–15.CrossRefPubMed
38.
Nettles R. Hyponatremia in a Patient With AIDS. Infect Dis Clin Pract. 2002;11(6):361–4.CrossRef
39.
Palmer BF. Hyponatremia in patients with central nervous system disease: SIADH versus CSW. Trends Endocrinol Metabolism. 2003;14(4):182–7.CrossRef
40.
Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17(6):432–7.CrossRefPubMed
41.
Shah S, Smith CJ, Lampe F, Youle M, Johnson MA, Phillips AN, Sabin CA. Haemoglobin and albumin as markers of HIV disease progression in the highly active antiretrovial therapy era: relationships with gender. HIV Med. 2007;8(1):38–45.CrossRefPubMed
42.
Mehta SH, Astemborski J, Sterling TR, Thomas DL, Vlahov D. Serum albumin as a prognostic indicator for HIV disease progression. AIDS Res Human Retroviruses. 2006;22(1):14–21.CrossRef
43.
Baslow MH. An answer to“The Nagging Question of the Function of N-Acetylaspartylglutamate”. Neurosci Commun. 2015;2:e844.
44.
Moffett JR, Ross B, Arun P, Madhavarao CN, Namboodiri AM. N-Acetylaspartate in the CNS: from neurodiagnostics to neurobiology. Prog Neurobiol. 2007;81(2):89–131.CrossRefPubMedPubMedCentral
45.
Danielsen ER, Ross B. Magnetic Resonance Spectroscopy Diagnosis of Neurological Disease. New York: Marcel Dekker; 1999.
46.
Lentz MR, Kim W-K, Kim H, Soulas C, Lee V, Venna N, Halpern EF, Rosenberg ES, Williams K, Gonzalez R. Alterations in brain metabolism during the first year of HIV infection. J Neurovirol. 2011;17(3):220–9.CrossRefPubMedPubMedCentral
47.
Urenjak J, Williams SR, Gadian DG, Noble M. Proton nuclear magnetic resonance spectroscopy unambiguously identifies different neural cell types. J Neurosci. 1993;13(3):981–9.PubMed
48.
Ernst T, Itti E, Itti L, Chang L. Changes in cerebral metabolism are detected prior to perfusion changes in early HIV‐CMC: A coregistered 1H MRS and SPECT study. J Magn Reson Imaging. 2000;12(6):859–65.CrossRefPubMed
49.
Chang L, Ernst T, Witt MD, Ames N, Gaiefsky M, Miller E. Relationships among brain metabolites, cognitive function, and viral loads in antiretroviral-naıve HIV patients. Neuroimage. 2002;17(3):1638–48.CrossRefPubMed
50.
Simone I, Federico F, Tortorella C, Andreula C, Zimatore G, Giannini P, Angarano G, Lucivero V, Picciola P, Carrara D. Localised 1H-MR spectroscopy for metabolic characterisation of diffuse and focal brain lesions in patients infected with HIV. J Neurol Neurosurg Psychiatry. 1998;64(4):516–23.CrossRefPubMedPubMedCentral
51.
Salvan A-M, 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(5):755–62.CrossRefPubMed
52.
Schousboe A. Role of astrocytes in the maintenance and modulation of glutamatergic and GABAergic neurotransmission. Neurochem Res. 2003;28(2):347–52.CrossRefPubMed
53.
Schousboe A, Waagepetersen HS. Role of astrocytes in glutamate homeostasis: implications for excitotoxicity. Neurotox Res. 2005;8(3–4):221–5.CrossRefPubMed
54.
Kou W, Banerjee S, Eudy J, Smith LM, Persidsky R, Borgmann K, Wu L, Sakhuja N, Deshpande MS, Walseth TF, et al. CD38 regulation in activated astrocytes: implications for neuroinflammation and HIV-1 brain infection. J Neurosci Res. 2009;87(10):2326–39.CrossRefPubMed
55.
Mamik MK, Banerjee S, Walseth TF, Hirte R, Tang L, Borgmann K, Ghorpade A. HIV-1 and IL-1β regulate astrocytic CD38 through mitogen-activated protein kinases and nuclear factor-kB signaling mechanisms. J Neuroinflammation. 2011;25(8):145.CrossRef
56.
Bruzzone S, Verderio C, Schenk U, Fedele E, Zocchi E, Matteoli M, De Flora A. Glutamate-mediated overexpression of CD38 in astrocytes cultured with neurones. J Neurochem. 2004;89(1):264–72.CrossRefPubMed
57.
Sailasuta N, Ross W, Ananworanich J, Chalermchai T, DeGruttola V, Lerdlum S, Pothisri M, Busovaca E, Ratto-Kim S, Jagodzinski L. Change in brain magnetic resonance spectroscopy after treatment during acute HIV infection. PLoS One. 2012;7(11):e49272.CrossRefPubMedPubMedCentral
58.
Harezlak J, Buchthal S, Taylor M, Schifitto G, Zhong J, Daar E, Alger J, Singer E, Campbell T, Yiannoutsos C, et al. Persistence of HIV-associated cognitive impairment, inflammation, and neuronal injury in era of highly active antiretroviral treatment. AIDS. 2011;25(5):625–33.CrossRefPubMedPubMedCentral
59.
Lentz M, Kim W, Lee V, Bazner S, Halpern E, Venna N, Williams K, Rosenberg E, Gonzalez R. Changes in MRS neuronal markers and T cell phenotypes observed during early HIV infection. Neurology. 2009;72(17):1465–72.CrossRefPubMedPubMedCentral
60.
Ernst T, Jiang CS, Nakama H, Buchthal S, Chang L. Lower brain glutamate is associated with cognitive deficits in HIV patients: A new mechanism for HIV-associated neurocognitive disorder. J Magn Reson Imaging. 2010;32(5):1045–53.CrossRefPubMedPubMedCentral
61.
Roc AC, Ances BM, Chawla S, Korczykowski M, Wolf RL, Kolson DL, Detre JA, Poptani H. Detection of human immunodeficiency virus–induced inflammation and oxidative stress in lenticular nuclei with magnetic resonance spectroscopy despite antiretroviral therapy. Arch Neurol. 2007;64(9):1249–57.CrossRefPubMed
Metadata
Title
Case control study: magnetic resonance spectroscopy of brain in HIV infected patients
Authors
Devender Bairwa
Virendra Kumar
Surabhi Vyas
Bimal Kumar Das
Achal Kumar Srivastava
Ravinder M. Pandey
Surendra K. Sharma
Naranamangalam R. Jagannathan
Sanjeev Sinha
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2016
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-016-0628-x

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