Di Sclafani V, Mackay R D, Meyerhoff D J, Norman D, Weiner M W, Fein G
Department of Psychiatry, University of California, San Francisco 94121, USA.
J Int Neuropsychol Soc. 1997 May;3(3):276-87.
HIV infection often results in MRI-detectable brain atrophy and white matter signal hyperintensities (WMSHs). Magnetic resonance images were obtained from 31 HIV+ male patients and 10 high-risk controls. Variation within the HIV+ group on neuropsychological (NP) impairment and stage of systemic disease were relatively independent, allowing examination of the relative association of MRI measures with NP impairment versus with systemic stage of disease. HIV+ patients compared to high-risk controls evidenced global atrophy, reduced caudate nuclei volume, and a trend to gray matter volume loss but no difference in white matter volume or in WMSHs. These effects were progressive with CDC clinical stage such that patients at CDC stage A had values very close to those of controls, while patients at CDC stage C had the most abnormal values. In contrast, the relationship between these MRI variables and severity of NP impairment was much less dramatic, with the mildly to moderately impaired HIV+ subjects showing MRI volume effects greater than or equal to those of the severely impaired HIV+ subjects. These results suggest that MRI-detectable brain atrophy secondary to HIV infection is not the primary substrate underlying the progressive NP impairment in HIV disease.
人类免疫缺陷病毒（HIV）感染常导致磁共振成像（MRI）可检测到的脑萎缩和白质信号高增强（WMSHs）。对31名HIV阳性男性患者和10名高危对照者进行了磁共振成像检查。HIV阳性组在神经心理学（NP）损害和全身疾病阶段方面的差异相对独立，这使得能够检验MRI测量值与NP损害以及与全身疾病阶段之间的相对关联。与高危对照者相比，HIV阳性患者表现出整体萎缩、尾状核体积减小以及灰质体积减少的趋势，但白质体积或WMSHs无差异。这些影响随着美国疾病控制与预防中心（CDC）临床阶段的进展而加重，以至于CDC A期患者的值与对照者非常接近，而CDC C期患者的值异常最为明显。相比之下，这些MRI变量与NP损害严重程度之间的关系则不那么显著，轻度至中度受损的HIV阳性受试者的MRI体积效应大于或等于重度受损的HIV阳性受试者。这些结果表明，HIV感染继发的MRI可检测到的脑萎缩并非HIV疾病中进行性NP损害的主要基础。
