HIV DEMENTIA AND THE BASAL GANGLIA

Infection with the human immunodeficiency virus frequently results in a dementing illness which manifests predominantly as a subcortical dem entia. Parkinsonian features may be prominent in these patients and ma y on occasion be the presenting manifestation. These patients are exqu isitely sensitive to dopaminergic blocking agents. Radiological studie s, metabolic uptake studies and pathological examination of the brain suggest that the basal ganglia are the major target of this infection. Although further studies are necessary to determine appropriate treat ment for this condition and to develop an understanding of the underly ing pathophysiological mechanisms, available evidence suggests that th e response to dopamine agonists may be variable and that viral strains and viral products may specifically target cells within the basal gan glia.