A MULTICENTER PROTON MAGNETIC-RESONANCE SPECTROSCOPY STUDY OF NEUROLOGICAL COMPLICATIONS OF AIDS

Human immunodeficiency virus (HIV) infection as seen in Europe and the United States has predominantly been contracted through male homosexu al sex or intravenous drug abuse, In infected subjects, the brain is f requently affected both clinically and neuropathologically. The aim of this multicenter study has been to evaluate the value of single-voxel proton magnetic resonance spectroscopy (MRS) in the assessment of the neurological complications of acquired immunodeficiency syndrome (AID S), MRS (voxel size = 8 ml, TR/TE = 1600/135 msec) was performed in 13 7 HIV-1-seropositive patients and 64 healthy controls without risk fac tors at three clinical MR sites operating at 1.5 T. The first result o f this multicenter trial is that good reproducibility of results among participating sites was found, This demonstrates the reliability and robustness of MRS in the study of in vivo brain metabolism. In HIV pat ients, there was no significant correlation between metabolite ratios of brain detected by MRS and CDC grouping of patients or CD4 count. In contrast, the variations of brain metabolite ratios (NA/Cr, NA/Cho, a nd Cho/Cr) were related to the occurrence of encephalopathy, brain atr ophy, or diffuse white matter lesions, There was no significant differ ence in brain metabolites between male homosexual AIDS patients and ma le intravenous drug user AIDS patients, whatever their neurological st atus (neurosymptomatic or neuroasymptomatic). Thus, the mode of transm ission of HIV infection does not appear to affect the cerebral changes observed in the proton spectra from AIDS patients, Because of its eas e of implementation and high information content, single-voxel proton MRS is likely to play a significant role in the evaluation of HIV-rela ted encephalopathies.