Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Lentz, M. R.
Right arrow Articles by González, R. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lentz, M. R.
Right arrow Articles by González, R. G.
Related Collections
Right arrow MRS
Right arrow All Infections
Right arrow Viral infections
Right arrow HIV
NEUROLOGY 2009;72:1465-1472
© 2009 American Academy of Neurology

Changes in MRS neuronal markers and T cell phenotypes observed during early HIV infection

M. R. Lentz, PhD, W. K. Kim, PhD, V. Lee, BA, S. Bazner, RN, E. F. Halpern, PhD, N. Venna, MD, MRCP, K. Williams, PhD, E. S. Rosenberg, MD and R. G. González, MD, PhD

From the Department of Neuroradiology/A.A. Martinos Center for Biomedical Imaging (M.R.L., V.L., E.F.H., R.G.G.), Department of Neurology (N.V.), and Departments of Medicine and Pathology/Partners AIDS Research Center (S.B., E.S.R.), Massachusetts General Hospital, Boston; Department of Microbiology and Molecular Cell Biology (W.K.K.), Eastern Virginia Medical School, Norfolk; and Biology Department (K.W.), Boston College, Boston.

Address correspondence and reprint requests to Dr. Margaret R. Lentz, Harvard Medical School/Massachusetts General Hospital, Building 149, 13th Street, Rm 2301, Charlestown, MA 02129 mlentz{at}nmr.mgh.harvard.edu

Objective: To determine if changes in brain metabolites are observed during early HIV infection and correlate these changes with immunologic alterations.

Methods: Eight subjects with early HIV infection, 9 HIV-seronegative controls, and 10 chronically HIV-infected subjects without neurologic impairment underwent 1H magnetic resonance spectroscopy. Subjects with early stage infection were identified near the time of HIV seroconversion and imaged within 60 days of an evolving Western blot, while still having detectable plasma virus. Subjects had blood drawn for viral RNA and T cell quantification.

Results: Both N-acetylaspartate (NAA) and Glx (glutamate + glutamine) were decreased in the frontal cortical gray matter of seropositive subjects. NAA levels were found to be decreased in the centrum semiovale white matter of chronically HIV-infected subjects, but not in those with early infection. Both HIV-infected cohorts demonstrated a lower number of CD4+ T lymphocytes and a higher number of CD8+ T lymphocytes in their blood. Lower NAA levels in the frontal cortex of subjects with early infection were associated with an expansion of CD8+ T cells, especially effector CD8+ T cells.

Conclusions: These results verify metabolism changes occurring in the brain early during HIV infection. Lower NAA and Glx levels in the cortical gray matter suggests that HIV causes neuronal dysfunction soon after infection, which correlates to the expansion of CD8+ T cells, specifically to an activated phenotype. Utilizing magnetic resonance spectroscopy to track NAA levels may provide important information on brain metabolic health while allowing better understanding of the virus–host interactions involved in CNS functional deficits.

Abbreviations: APC = allophycocyanin; Cho = choline; Cr = creatine; CTL = cytotoxic T lymphocyte; Cy5.5 = cyanin 5.5; FITC = fluorescein isothiocyanate; FOV = field of view; Glx = glutamate + glutamine; MI = myoinositol; MRS = magnetic resonance spectroscopy; NAA = N-acetylaspartate; NRTI = nucleoside reverse transcriptase inhibitors; PE = phycoerythrin; PerCP = peridinium chlorophyll protein; PHI = primary HIV infection; SIV = simian immunodeficiency virus; TE = echo time; TI = inversion time; TR = repetition time.

*Drs. Lentz and Kim are co-first authors.

Supported by NIH grants NS051129 (M.R.L.), NS040237 (K.W.), NS037654 and U19MH81835 (K.W.), NS050041 (R.G.G.), AI040873 (E.S.R.), the National Center for Research Resources (P41 RR14075), and the Mental Illness and Neuroscience Discovery (MIND) Institute.

Disclosure: The authors report no disclosures.

Medical Devices: Amplicor Monitor (Roche, Indianapolis, IN); Signa scanner (General Electric, Milwaukee, WI).

Received September 25, 2008. Accepted in final form January 27, 2009.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2009 by AAN Enterprises, Inc.