Perfusion MRI detects rCBF abnormalities in early stages of HIV-cognitive motor complex

Objective: To evaluate patients with early HIV-cognitive motor complex (HIV -CMC) for possible regional cerebral blood flow (rCBF) abnormalities on per fusion MRI (pMRI). Background: Nuclear medicine techniques have demonstrate d global and focal cerebral perfusion abnormalities in patients with HIV de mentia. Ultrafast pMRI enables the measurement of rCBF throughout the brain without the need to apply radioactive tracers or ionizing radiation, Metho ds: pMRI was used to measure the rCBF in 19 patients with early stages of H IV-CMC and 15 healthy seronegative control subjects. The rCBF maps were reg istered to high-resolution anatomic MRI scans and transformed into Talairac h space. Statistical analysis of the rCBF maps was performed with SPM96, Re sults: Compared with the control subjects, the patients with HIV had statis tically significantly decreased rCBF bilaterally in the inferior lateral fr ontal cortices (right: -15%, p < 0.002; left: -12%, p < 0.005) and in the i nferior medial parietal brain region (-15%, p < 0.0009). In contrast, rCBF was increased bilaterally in the posterior inferior parietal white matter ( right: +19%, p < 0.0001; left: +17%, p < 0.001), Furthermore, rCBF abnormal ities correlated significantly with clinical disease severity as measured b y CD4 count, plasma viral load, Karnofsky score, and HIV dementia scale. Di scussion: Our results are consistent with previous findings from PET and SP ECT studies. Furthermore, pMRI can detect rCBF abnormalities that correlate with disease severity in HIV-CMC, Because pMRI is more cost-effective, fas ter, and safer than nuclear medicine techniques for monitoring rCBF changes , pMRI may be more feasible for monitoring the effects of therapy for HIV-C MC.