di Rocco A, Bottiglieri T, Dorfman D, Werner P, Morrison C, Simpson D
Department of Neurology, Beth Israel Medical Center, Albert Einstein College of Medicine, New York, New York 10003, USA.
Clin Neuropharmacol. 2000 Jul-Aug;23(4):190-4. doi: 10.1097/00002826-200007000-00004.
To determine whether dopamine metabolism is abnormal in HIV infected patients and whether dopamine metabolism abnormalities are related to specific neuropsychologic characteristics in HIV-infected patients, we measured cerebrospinal fluid (CSF) levels of homovanilic acid (HVA), the primary dopamine metabolite, in 10 HIV-infected patients and compared it to HVA levels in CSF in a group of 13 healthy control subjects. HIV-infected patients were also assessed with a battery of neuropsychologic tests and HVA levels were then correlated with performance on specific neuropsychologic tests. The mean (+/-SD) HVA level in CSF was 100.9 +/- 29.3 nmol/L in the HIV-infected study group and 230.5 +/- 50.0 nmol/L in the non-HIV-infected control group (p < 0.0001). The decrease in concentrations of HVA in CSF correlated with impairment on performance on neuropsychologic testing (Spearman r = 0.67; p = 0.03). When the relationship between HVA levels and specific cognitive domains was evaluated, we observed trends for positive correlation between HVA levels and tests that measure motor speed (r = 0.59; p = 0.074) and those testing attention, concentration, and executive control (r = 0.54; p = 0.108). There was no relationship between performance on memory tests and CSF HVA levels (r = -0.0061; p = 0.987). These results further support the hypothesis that dopaminergic dysfunction plays an important role in the pathogenesis of AIDS dementia complex (ADC) and suggest that specific motor and cognitive abnormalities may be related to depressed dopaminergic activity. This may have important implications for the development of treatments or preventive strategies for ADC.
为了确定多巴胺代谢在HIV感染患者中是否异常，以及多巴胺代谢异常是否与HIV感染患者特定的神经心理特征相关，我们测量了10名HIV感染患者脑脊液（CSF）中主要多巴胺代谢产物高香草酸（HVA）的水平，并将其与13名健康对照受试者脑脊液中的HVA水平进行比较。还对HIV感染患者进行了一系列神经心理测试，并将HVA水平与特定神经心理测试的表现进行关联。HIV感染研究组脑脊液中HVA的平均（±标准差）水平为100.9±29.3 nmol/L，非HIV感染对照组为230.5±50.0 nmol/L（p<0.0001）。脑脊液中HVA浓度的降低与神经心理测试表现受损相关（斯皮尔曼r=0.67；p=0.03）。当评估HVA水平与特定认知领域之间的关系时，我们观察到HVA水平与测量运动速度的测试（r=0.59；p=0.074）以及测试注意力、专注力和执行控制的测试（r=0.54；p=0.108）之间存在正相关趋势。记忆测试表现与脑脊液HVA水平之间无相关性（r=-0.0061；p=0.987）。这些结果进一步支持了多巴胺能功能障碍在艾滋病痴呆综合征（ADC）发病机制中起重要作用的假设，并表明特定的运动和认知异常可能与多巴胺能活性降低有关。这可能对ADC治疗或预防策略的开发具有重要意义。
