Masliah E, Heaton R K, Marcotte T D, Ellis R J, Wiley C A, Mallory M, Achim C L, McCutchan J A, Nelson J A, Atkinson J H, Grant I
Department of Neurosciences, University of California, San Diego, La Jolla 92093-0624, USA.
Ann Neurol. 1997 Dec;42(6):963-72. doi: 10.1002/ana.410420618.
To determine the neuropathological substrate of human immunodeficiency virus (HIV)-associated neurocognitive disorders, we examined persons with acquired immunodeficiency syndrome before their death and related their antemortem neuropsychological performance to postmortem indicators of HIV encephalitis, viral burden, and presynaptic and postsynaptic neuronal injury. Of 20 prospectively examined cases, 9 were neurocognitively normal, 5 showed neuropsychological impairment, 5 had minor cognitive/motor disorder, and 1 was demented. Degree of neurocognitive impairment was strongly related to the amount of dendritic simplification based on microtubule-associated protein 2 immunohistochemical staining, somewhat less so to a semiquantitative viral burden score based on numbers of HIV gp41-immunoreactive cells, and much less so to the presence of multinucleated giant cells or microglial nodules. It appears that even milder neurocognitive impairment reflects microneuroanatomical injury to synaptic structures.
为了确定人类免疫缺陷病毒（HIV）相关神经认知障碍的神经病理学基础，我们在患者死亡前对获得性免疫缺陷综合征患者进行了检查，并将其生前神经心理学表现与死后HIV脑炎、病毒载量以及突触前和突触后神经元损伤的指标相关联。在20例前瞻性检查的病例中，9例神经认知正常，5例表现出神经心理学损害，5例有轻度认知/运动障碍，1例患有痴呆症。神经认知障碍的程度与基于微管相关蛋白2免疫组化染色的树突简化程度密切相关，与基于HIV gp41免疫反应性细胞数量的半定量病毒载量评分的相关性稍弱，与多核巨细胞或小胶质结节的存在相关性更弱。看来，即使是较轻的神经认知障碍也反映了突触结构的微神经解剖学损伤。
