HIV dementia: the role of the basal ganglia and dopaminergic systems

The clinical features of human immunodefiency virus (HIV) dementia exhibit title hallmarks of a subcortical dementia. These features include psychomot or slowing, apathy, bradykinesia and altered posture and gait similar to th ose observed in advanced Parkinson's disease. The dementia has the hallmark s attributed to subcortical dementia. The exquisite sensitivity of many of these patients to dopamine receptor blockade suggested a profound and, perh aps, selective abnormality of striatal dopaminergic systems. Additional inv estigations, electrophysiological, pathological, virological, metabolic and radiological studies, indicate that the basal ganglia are a major target o f HIV infection. In this review, we describe the evidence for involvement o f basal ganglia and, in particular, the dopaminergic systems, in HIV dement ia. We also suggest novel therapeutic strategies that may be beneficial in the treatment of this disorder.