Department of Psychological Medicine, King's College London, Institute of Psychiatry, London, United Kingdom, SE5 8AF.
Hum Brain Mapp. 2013 Oct;34(10):2484-93. doi: 10.1002/hbm.22078. Epub 2012 Apr 12.
Despite advances in the treatment of patients with human immunodeficiency virus (HIV), HIV-associated neurocognitive disorder occurs in 15-50% of HIV-infected individuals, and may become more apparent as ageing advances. In the present study we investigated regional cerebral blood flow (rCBF) and regional cerebral metabolic rate of glucose uptake (rCMRglc) in medically and psychiatrically stable HIV-1-infected participants in two age-groups. Positron emission tomography (PET) and magnetic resonance imaging (MRI)-based arterial spin labeling (ASL) were used to measure rCMRglc and rCBF, respectively, in 35 HIV-infected participants and 37 HIV-negative matched controls. All participants were currently asymptomatic with undetectable HIV-1 viral loads, without medical or psychiatric comorbidity, alcohol or substance misuse, stable on medication for at least 6 months before enrolment in the study. We found significant age effects on both ASL and PET with reduced rCBF and rCMRglc in related frontal brain regions, and consistent, although small, reductions in rCBF and rCMRglc in the anterior cingulate cortex (ACC) in HIV, a finding of potential clinical significance. There was no significant interaction between HIV status and the ageing process, and no significant HIV-related changes elsewhere in the brain on PET or ASL. This is the first paper to combine evidence from ASL and PET method in HIV participants. These finding provide evidence of crossvalidity between the two techniques, both in ageing and a clinical condition (HIV).
尽管在治疗人类免疫缺陷病毒 (HIV) 患者方面取得了进展，但 HIV 相关神经认知障碍仍在 15-50%的 HIV 感染者中发生，并且随着年龄的增长可能会变得更加明显。在本研究中，我们研究了两个年龄组中医学和精神上稳定的 HIV-1 感染者参与者的局部脑血流 (rCBF) 和局部脑葡萄糖摄取代谢率 (rCMRglc)。正电子发射断层扫描 (PET) 和基于磁共振成像 (MRI) 的动脉自旋标记 (ASL) 分别用于测量 35 名 HIV 感染者和 37 名 HIV 阴性匹配对照者的 rCMRglc 和 rCBF。所有参与者目前均无症状，HIV-1 病毒载量无法检测，无医学或精神共病、酒精或药物滥用，在研究入组前至少 6 个月接受药物治疗后病情稳定。我们发现 ASL 和 PET 都存在显著的年龄效应，相关额叶脑区的 rCBF 和 rCMRglc 降低，而 HIV 患者的前扣带回皮层 (ACC) 中 rCBF 和 rCMRglc 则持续但较小幅度地降低，这一发现具有潜在的临床意义。HIV 状态和衰老过程之间没有显著的相互作用，PET 或 ASL 也没有在大脑的其他部位发现与 HIV 相关的显著变化。这是第一篇将 ASL 和 PET 方法结合到 HIV 参与者中的论文。这些发现为这两种技术在衰老和临床状况（HIV）中的交叉有效性提供了证据。
