CEREBRAL PROTON SPECTROSCOPY IN PATIENTS WITH HUMAN-IMMUNODEFICIENCY-VIRUS INFECTION

BACKGROUND: This article presents a combined magnetic resonance imagin g and proton spectroscopy protocol (MRI/H-1-MRS) applied to study the brain of human immunodeficiency Virus (HIV) infected patients, The spe ctroscopic results were compared with clinical and radiological parame ters. PATIENTS AND METHODS: The proton spectra of 57 HIV patients and 20 control subjects were obtained from a volume of interest of 8 cm(3) located in the parietooccipital region of the brain that did not incl ude any focal lesion, The resonance areas due to N-acetyl aspartate (N AA), creatine (Cr) and choline (Cho) were obtained, The MRI exam allow ed us to determine the presence of focal or diffuse lesions and the de gree of atrophy. Finally, the clinical exploration included the perfor mance of a Mini-Mental test. The NAA/Cr, NAA/Cho and Cho/Cr ratios wer e correlated with clinical characteristics, the result of the Mini-Men tal test, the presence of lesions and the degree of atrophy. RESULTS: There were altered spectral patterns in a volume of the brain that did not contain any focal lesion. The decrease in the NAA/Cr or NAA/Cho r atios was significative when considering the presence of atrophy, the existence of signs of cognitive deficiencies or the diagnosis of AIDS- dementia complex, CONCLUSIONS: The spectral changes found in the prese nt study suggest the existence of neuronal lesions that would be due t o the HIV-infection. A combined MRI/H-1-MRS study may provide a more c omplete information about the neurological impairment by HIV and could constitute a marker of AIDS-dementia complex.