Abstract

There is a lack of data about the long-term follow-up changes in neurometabolic profile and neuropsychological performance of HIV-positive subjects under continuous antiretroviral therapy (cART). The aim of the study was to assess changes in neurometabolic profile in chronically-infected, HIV-positive subjects during a five-year follow-up period, using multi-voxel proton magnetic resonance spectroscopy (1H-MRS). Nineteen neurologically asymptomatic, aviremic, HIV-positive subjects, underwent multi-voxel 2D MRS on a 3 T MR unit and synchronous neurocognitive assessment in a five-year follow-up period. Twelve voxels were placed in prefrontal cortices, anterior and posterior cingulate gyrus, intraparietal sulci, and frontal centrum semiovale white matter, to identify peaks of N-acetyl-aspartate (NAA), creatine (Cr), choline (Cho), and myoinositol (mI). Ratios of NAA/Cr, NAA/Cho, NAA/mI, mI/Cr, and Cho/Cr were analyzed. Longitudinal differences in ratios and neurocognitive scores were tested with the Wilcoxon signed-rank-test. Statistical significance was set at p ≤ 0.004 significant, and 0.05 > p > 0.004 trending toward significance. A significant longitudinal increase in NAA/Cr ratio was observed in 5/12 voxels, while there was a trend toward significance in an additional three. The increase in Cho/Cr reached statistical significance in one voxel. Changes in the mI/Cr ratio demonstrated a significant increase in 4/12 voxels. A progressive increase in NAA/Cr, followed by better neurocognitive performance, may be an indicator of brain plasticity in the setting of chronic HIV-related neuronal injury. A progressive mI/Cr increase could be partly explained by glial proliferation due to functional compartment remodeling and partly attributable to insufficient control of persistent neuroinflammation by cART.

Details

Title
Neurometabolic Remodeling in Chronic Hiv Infection: a Five-Year Follow-up Multi-Voxel Mrs Study
Author
Boban, Jasmina 1   VIAFID ORCID Logo  ; Thurnher, Majda M 2 ; Brkic, Snezana 3 ; Lendak, Dajana 4 ; Vojislava Bugarski Ignjatovic 5 ; Todorovic, Aleksandar 1 ; Kozic, Dusko 1 

1  University of Novi Sad, Faculty of Medicine Novi Sad, Novi Sad, Serbia; Oncology Institute of Vojvodina, Center for Diagnostic Imaging, Sremska Kamenica, Serbia 
2  Medical University of Vienna, Department fo Biomedical Imaging and Image-guided Therapy, Vienna, Austria 
3  University of Novi Sad, Faculty of Medicine Novi Sad, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic for Infectious Diseases, Novi Sad, Serbia 
4  University of Novi Sad, Faculty of Medicine Novi Sad, Novi Sad, Serbia; Medical University of Vienna, Department fo Biomedical Imaging and Image-guided Therapy, Vienna, Austria 
5  University of Novi Sad, Faculty of Medicine Novi Sad, Novi Sad, Serbia; Clinical Center of Vojvodina, Clinic for Neurology, Novi Sad, Serbia 
Pages
1-11
Publication year
2019
Publication date
Dec 2019
Publisher
Nature Publishing Group
e-ISSN
20452322
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41598-019-56330-0
ProQuest document ID
2330312716
Copyright
© 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.