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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1994 Feb;57(2):144–149. doi: 10.1136/jnnp.57.2.144

Serial MRI of the brain in asymptomatic patients infected with HIV: results from the UCMSM/Medical Research Council neurology cohort.

H Manji 1, S Connolly 1, R McAllister 1, A R Valentine 1, B E Kendall 1, M Fell 1, P Durrance 1, A J Thompson 1, S Newman 1, I V Weller 1, et al.
PMCID: PMC1072439  PMID: 8126495

Abstract

Seventy-six homosexual or bisexual men underwent two cranial MRI studies at a mean interval of 13 months; 23 were HIV seronegative, 41 seropositive but asymptomatic (Center for Disease Control (CDC) groups II/III), and 12 had AIDS related complex (ARC)/AIDS (CDC group IV). Agreement between two neuroradiologists was rated as very good for assessment of enlargement of ventricles and good for widening of cerebral sulci and the presence of focal lesions. For assessment of serial studies, the agreement was moderate. The prevalence of cerebral atrophy and focal white matter lesions was no higher in the asymptomatic patients (CDC group II/III) than in appropriate seronegative controls. Some patients with ARC/AIDS showed evidence of developing cerebral atrophy during the study period when serial scans were compared. The imaging evidence supports the other data obtained from this cohort, which suggest that no significant CNS involvement occurs in HIV infection before the development of ARC/AIDS.

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Selected References

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  1. Awad I. A., Johnson P. C., Spetzler R. F., Hodak J. A. Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. II. Postmortem pathological correlations. Stroke. 1986 Nov-Dec;17(6):1090–1097. doi: 10.1161/01.str.17.6.1090. [DOI] [PubMed] [Google Scholar]
  2. Awad I. A., Spetzler R. F., Hodak J. A., Awad C. A., Carey R. Incidental subcortical lesions identified on magnetic resonance imaging in the elderly. I. Correlation with age and cerebrovascular risk factors. Stroke. 1986 Nov-Dec;17(6):1084–1089. doi: 10.1161/01.str.17.6.1084. [DOI] [PubMed] [Google Scholar]
  3. Bentson J., Reza M., Winter J., Wilson G. Steroids and apparent cerebral atrophy on computed tomography scans. J Comput Assist Tomogr. 1978 Jan;2(1):16–23. doi: 10.1097/00004728-197801000-00003. [DOI] [PubMed] [Google Scholar]
  4. Brennan P., Silman A. Statistical methods for assessing observer variability in clinical measures. BMJ. 1992 Jun 6;304(6840):1491–1494. doi: 10.1136/bmj.304.6840.1491. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Carne C. A., Tedder R. S., Smith A., Sutherland S., Elkington S. G., Daly H. M., Preston F. E., Craske J. Acute encephalopathy coincident with seroconversion for anti-HTLV-III. Lancet. 1985 Nov 30;2(8466):1206–1208. doi: 10.1016/s0140-6736(85)90740-8. [DOI] [PubMed] [Google Scholar]
  6. Denning D. W., Anderson J., Rudge P., Smith H. Acute myelopathy associated with primary infection with human immunodeficiency virus. Br Med J (Clin Res Ed) 1987 Jan 17;294(6565):143–144. doi: 10.1136/bmj.294.6565.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Everall I. P., Luthert P. J., Lantos P. L. Neuronal loss in the frontal cortex in HIV infection. Lancet. 1991 May 11;337(8750):1119–1121. doi: 10.1016/0140-6736(91)92786-2. [DOI] [PubMed] [Google Scholar]
  8. Fahey J. L., Taylor J. M., Detels R., Hofmann B., Melmed R., Nishanian P., Giorgi J. V. The prognostic value of cellular and serologic markers in infection with human immunodeficiency virus type 1. N Engl J Med. 1990 Jan 18;322(3):166–172. doi: 10.1056/NEJM199001183220305. [DOI] [PubMed] [Google Scholar]
  9. Gerard G., Weisberg L. A. MRI periventricular lesions in adults. Neurology. 1986 Jul;36(7):998–1001. doi: 10.1212/wnl.36.7.998. [DOI] [PubMed] [Google Scholar]
  10. Grant I., Atkinson J. H., Hesselink J. R., Kennedy C. J., Richman D. D., Spector S. A., McCutchan J. A. Evidence for early central nervous system involvement in the acquired immunodeficiency syndrome (AIDS) and other human immunodeficiency virus (HIV) infections. Studies with neuropsychologic testing and magnetic resonance imaging. Ann Intern Med. 1987 Dec;107(6):828–836. doi: 10.7326/0003-4819-107-6-828. [DOI] [PubMed] [Google Scholar]
  11. Haas J. S., Bolan G., Larsen S. A., Clement M. J., Bacchetti P., Moss A. R. Sensitivity of treponemal tests for detecting prior treated syphilis during human immunodeficiency virus infection. J Infect Dis. 1990 Oct;162(4):862–866. doi: 10.1093/infdis/162.4.862. [DOI] [PubMed] [Google Scholar]
  12. Ho D. D., Sarngadharan M. G., Resnick L., Dimarzoveronese F., Rota T. R., Hirsch M. S. Primary human T-lymphotropic virus type III infection. Ann Intern Med. 1985 Dec;103(6 ):880–883. doi: 10.7326/0003-4819-103-6-880. [DOI] [PubMed] [Google Scholar]
  13. Lacey J. N., Forbes M. A., Waugh M. A., Cooper E. H., Hambling M. H. Serum beta 2-microglobulin and human immunodeficiency virus infection. AIDS. 1987 Jul;1(2):123–127. [PubMed] [Google Scholar]
  14. Levy R. M., Mills C. M., Posin J. P., Moore S. G., Rosenblum M. L., Bredesen D. E. The efficacy and clinical impact of brain imaging in neurologically symptomatic AIDS patients: a prospective CT/MRI study. J Acquir Immune Defic Syndr. 1990;3(5):461–471. [PubMed] [Google Scholar]
  15. McAllister R. H., Herns M. V., Harrison M. J., Newman S. P., Connolly S., Fowler C. J., Fell M., Durrance P., Manji H., Kendall B. E. Neurological and neuropsychological performance in HIV seropositive men without symptoms. J Neurol Neurosurg Psychiatry. 1992 Feb;55(2):143–148. doi: 10.1136/jnnp.55.2.143. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. McArthur J. C., Cohen B. A., Selnes O. A., Kumar A. J., Cooper K., McArthur J. H., Soucy G., Cornblath D. R., Chmiel J. S., Wang M. C. Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1-infected individuals: results from the multicenter AIDS Cohort Study. Ann Neurol. 1989 Nov;26(5):601–611. doi: 10.1002/ana.410260504. [DOI] [PubMed] [Google Scholar]
  17. McArthur J. C., Kumar A. J., Johnson D. W., Selnes O. A., Becker J. T., Herman C., Cohen B. A., Saah A. Incidental white matter hyperintensities on magnetic resonance imaging in HIV-1 infection. Multicenter AIDS Cohort Study. J Acquir Immune Defic Syndr. 1990;3(3):252–259. [PubMed] [Google Scholar]
  18. Post M. J., Tate L. G., Quencer R. M., Hensley G. T., Berger J. R., Sheremata W. A., Maul G. CT, MR, and pathology in HIV encephalitis and meningitis. AJR Am J Roentgenol. 1988 Aug;151(2):373–380. doi: 10.2214/ajr.151.2.373. [DOI] [PubMed] [Google Scholar]
  19. Price R. W., Brew B., Sidtis J., Rosenblum M., Scheck A. C., Cleary P. The brain in AIDS: central nervous system HIV-1 infection and AIDS dementia complex. Science. 1988 Feb 5;239(4840):586–592. doi: 10.1126/science.3277272. [DOI] [PubMed] [Google Scholar]
  20. Selnes O. A., Miller E., McArthur J., Gordon B., Muñoz A., Sheridan K., Fox R., Saah A. J. HIV-1 infection: no evidence of cognitive decline during the asymptomatic stages. The Multicenter AIDS Cohort Study. Neurology. 1990 Feb;40(2):204–208. doi: 10.1212/wnl.40.2.204. [DOI] [PubMed] [Google Scholar]
  21. Sönnerborg A., Säf J., Alexius B., Strannegård O., Wahlund L. O., Wetterberg L. Quantitative detection of brain aberrations in human immunodeficiency virus type 1-infected individuals by magnetic resonance imaging. J Infect Dis. 1990 Dec;162(6):1245–1251. doi: 10.1093/infdis/162.6.1245. [DOI] [PubMed] [Google Scholar]
  22. Wilkie F. L., Eisdorfer C., Morgan R., Loewenstein D. A., Szapocznik J. Cognition in early human immunodeficiency virus infection. Arch Neurol. 1990 Apr;47(4):433–440. doi: 10.1001/archneur.1990.00530040085022. [DOI] [PubMed] [Google Scholar]
  23. Zeman A., Donaghy M. Acute infection with human immunodeficiency virus presenting with neurogenic urinary retention. Genitourin Med. 1991 Aug;67(4):345–347. doi: 10.1136/sti.67.4.345. [DOI] [PMC free article] [PubMed] [Google Scholar]

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