Cerebral white matter Hyperintensities in HIV-positive patients

被引：12

作者：

Trentalange, Alice ^{[1
]}

Prochet, Adolfo ^{[2
]}

Imperiale, Daniele ^{[3
]}

Cusato, Jessica ^{[1
]}

Tettoni, Mariacristina ^{[1
]}

Nunnari, Giuseppe ^{[4
]}

Barco, Ambra ^{[1
]}

Bonora, Stefano ^{[1
]}

Di Perri, Giovanni ^{[1
]}

Calcagno, Andrea ^{[1
]}

机构：

[1] Univ Torino, Dept Med Sci, Unit Infect Dis, Osped Amedeo Savoia, Cso Svizzera 164, I-10159 Turin, Italy

[2] San Giovanni Bosco Hosp, Dept Radiol, Turin, Italy

[3] Maria Vittoria Hosp, Dept Neurol, ASL TO2, Turin, Italy

[4] Univ Messina, Dept Clin & Expt Med, Unit Infect Dis, Messina, Italy

来源：

BRAIN IMAGING AND BEHAVIOR | 2020年 / 14卷 / 01期

关键词：

HIV; Neurocognition; Brain magnetic resonance imaging; Neopterin; Visual scale; CENTRAL-NERVOUS-SYSTEM; CEREBROSPINAL-FLUID; NEUROCOGNITIVE IMPAIRMENT; COGNITIVE IMPAIRMENT; BLOOD-PRESSURE; RISK-FACTORS; INFECTION; LESIONS; DISEASE; OLDER;

D O I：

10.1007/s11682-018-9966-1

中图分类号：

R445 [影像诊断学];

学科分类号：

100207 ;

摘要：

White matter hyperintensities (WMHs) have been associated with neurological complications including cognitive impairment. WMHs have been often described in HIV positive subjects and they have been linked to neurocognitive impairment, cerebrospinal fluid (CSF) residual viral replication and biomarkers of monocyte activation. Aim of this study was to grade WMHs in HIV-positive individuals using a simple visual scale and to explore their severity with clinical, neurocognitive and biomarker characteristics. Brain MRIs were retrospectively evaluated by two reviewers who rated WMHs following the "age-related white matter changes (ARWMC)" scale. 107 adult HIV-positive patients receiving lumbar punctures for clinical reasons were included. 70 patients (66.6%) were diagnosed with WMHs. Average WMH scores were higher in treated [7 (1-11)] vs. naive individuals [3 (0-6)] (p = 0.008). Higher WHMs scores were observed in patients with chronic renal impairment along with chronic hepatitis (naive) and longer HIV duration (treated participants). No consistent associations between plasma, CSF biomarkers and WMHs scores were found. 45 patients underwent full neurocognitive tests and WMHs scores were non-significantly higher in patients diagnosed with HAND [6.5 (0.5-8.3) vs. 1.5 (0-7), p = 0.165]; screening (IHDS and FAB), visuo-spatial (Corsi's) and auditory-verbal memory (disillabic words repetition) tests scored worse in patients with higher WMHs. In our population of HIV-positive patients with low CD4 nadir and partial CD4 cell recovery the burden of WMHs was associated with the duration of HIV infection and with commonly observed comorbidities (such as renal and hepatic impairment). Given the association with worse neurocognition, further studies on tailored interventions are needed.

引用

页码：10 / 18

页数：9

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