Cerebral metabolite changes prior to and after antiretroviral therapy in primary HIV infection
| Autor: | Julia Peterson, Serena Spudich, Manu Hegde, Rudy Walter, Dieter J. Meyerhoff, Evelyn Lee, Constantin T. Yiannoutsos, Andrew C. Young, Richard W. Price |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Pathology Magnetic Resonance Spectroscopy Metabolite Clinical Sciences Excitotoxicity HIV Infections medicine.disease_cause Creatine Article Phosphocreatine chemistry.chemical_compound Clinical Research Internal medicine Behavioral and Social Science Basal ganglia medicine Humans Longitudinal Studies Cerebrum Neurology & Neurosurgery business.industry Neurosciences Glutamate receptor Middle Aged Infectious Diseases medicine.anatomical_structure Endocrinology Anti-Retroviral Agents Gliosis chemistry Chronic Disease HIV/AIDS Female Cognitive Sciences Neurology (clinical) medicine.symptom business |
| Zdroj: | Young, AC; Yiannoutsos, CT; Hegde, M; Lee, E; Peterson, J; Walter, R; et al.(2014). Cerebral metabolite changes prior to and after antiretroviral therapy in primary HIV infection. Neurology, 83(18), 1592-1600. doi: 10.1212/WNL.0000000000000932. UCSF: Retrieved from: http://www.escholarship.org/uc/item/0tt7184t Neurology, vol 83, iss 18 |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/wnl.0000000000000932 |
| Popis: | © 2014 American Academy of Neurology. Objective: We examined the longitudinal effects of primary HIV infection (PHI) and responses to early antiretroviral therapy (ART) on the brain using high-field magnetic resonance spectroscopy (MRS). Methods: Cerebral metabolites were measured longitudinally with 4T proton MRS and assessed for ART effects in participants with PHI. Levels of glutamate (Glu), N-acetylaspartate (NAA), myo-inositol (MI), and choline-containingmetabolites (Cho) weremeasured relative to creatine1 phosphocreatine (Cr) in anterior cingulate, basal ganglia, frontal white matter, and parietal gray matter. Results: Fifty-three participants recruited at median 3.7 months post HIV transmission were followed a median 6.0 months. A total of 23 participants initiated ART during follow-up. Prior to ART, increases per month were observed in Cho/Cr (slope 5 0.0012, p = 0.005) and MI/Cr (slope 5 0.0041, p = 0.005) in frontal white matter as well as increases in MI/Cr (slope 5 0.0041, p < 0.001) and NAA/Cr (slope 5 0.0024, p = 0.030) in parietal gray matter. After initiation of ART, prior positive slopes were no longer significantly different from zero, while Glu/Cr in basal ganglia decreased (slope 5 -0.0038, p = 0.031). Conclusions: Early in HIV infection, increases of Cho/Cr and MI/Cr in treatment-naive participants suggest progressive inflammation and gliosis in the frontal white matter and parietal gray matter, which is attenuated after initiation of ART. Elevated baseline Glu/Cr in basal ganglia may signal excitotoxicity; its subsequent stabilization and downward trajectory with ART may lend further support for early ART initiation. |
| Databáze: | OpenAIRE |
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