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01-06-2009 | Original Communication

Substantia nigra hyperechogenicity and CSF dopamine depletion in HIV

Authors: Mark Obermann, M. Küper, O. Kastrup, O. Yaldizli, S. Esser, J. Thiermann, E. Koutsilieri, G. Arendt, H.-C. Diener, M. Maschke, for the German Competence Network HIV/AIDS

Published in: Journal of Neurology | Issue 6/2009

Abstract

Dopaminergic dysfunction is thought to play a pivotal role in human immunodeficiency virus (HIV)-related dementia. Decreased dopamine (DA) levels in the cerebrospinal fluid (CSF) and neuronal loss in the substantia nigra (SN) have been reported in HIV-infected patients, suggesting nigrostriatal damage. Structural changes detectable as hyperechogenicity in transcranial ultrasound (TCS) scans of the SN have been reported in patients with Parkinson’s disease (PD) and other neurological conditions. In this study, we assessed the echomorphology of the SN in 40 HIV-positive patients compared to 40 age- and sex-matched healthy controls and correlated these findings with CSF levels of DA and the metabolites homovanillic acid (HVA) and 3,4-dihydroxy phenylacetic acid (DOPAC) and with neuropsychologic performance. We observed that the SN of HIV-infected patients was hyperechogenic relative to that of controls (0.07 ± 0.05 vs. 0.04 ± 0.07 cm²; mean ± SEM; P < 0.001) and that this SN hyperechogenicity was correlated with decreased DA levels in the CSF, decreased CD4 cell count, and an impaired performance in the psychopathology assessment scale (AMDP) subtest for drive and psychomobility. An association to CDC stage, duration of HIV infection, or presence of HIV dementia was not observed. Our results indicate changes in the nigrostriatal system in HIV-infected patients that are detectable as hyperechogenic SN precede prominent extrapyramidal symptoms and cognitive dysfunction.

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Title: Substantia nigra hyperechogenicity and CSF dopamine depletion in HIV
Authors: Mark Obermann
M. Küper
O. Kastrup
O. Yaldizli
S. Esser
J. Thiermann
E. Koutsilieri
G. Arendt
H.-C. Diener
M. Maschke
for the German Competence Network HIV/AIDS
Publication date: 01-06-2009
Publisher: D. Steinkopff-Verlag
Published in: Journal of Neurology / Issue 6/2009
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-009-5052-3

At a glance: The STEP trials

Springer Medicine

Substantia nigra hyperechogenicity and CSF dopamine depletion in HIV

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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