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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1997 Oct;63(4):477–482. doi: 10.1136/jnnp.63.4.477

Proton MRS and quantitative MRI assessment of the short term neurological response to antiretroviral therapy in AIDS

I Wilkinson 1, S Lunn 1, K Miszkiel 1, R Miller 1, M Paley 1, I Williams 1, R Chinn 1, M Hall-Craggs 1, S Newman 1, B Kendall 1, M Harrison 1
PMCID: PMC2169781  PMID: 9343127

Abstract

OBJECTIVE—To investigate MRI and proton spectroscopy changes in five patients with HIV associated dementia complex (HADC) treated with antiretroviral therapy.
METHODS—Three markers were evaluated: (1) CSF/intracranial volume ratio; (2) T2 weighted signal ratio between parieto-occipital white and subcortical grey matter; and (3) metabolite ratios from long echo time (TE=135 ms) single voxel proton spectra of parieto-occipital white matter.
RESULTS—Spectroscopic changes indicated initial increases in N-acetyl/(N-acetyl + choline + creatine) ratio (NA/(NA+ Cho+Cr)) and progression of atrophy after initiation of antiretroviral therapy in four of five patients. When the neurological status of the patients subsequently deteriorated (two of five patients), the NA/(NA+Cho+Cr) ratio also declined.
CONCLUSIONS—spectroscopic changes mirror reversible neuronal dysfunction. These objective, non-invasive techniques may be used for monitoring the neurological effects of antiretroviral drug therapy in patients with HADC.



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Selected References

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