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NEUROLOGY 2006;66:862-866
© 2006 American Academy of Neurology

Caudate blood flow and volume are reduced in HIV+ neurocognitively impaired patients

B. M. Ances, MD, PhD*, A. C. Roc, MS*, J. Wang, PhD, M. Korczykowski, MA, J. Okawa, MSN, J. Stern, MD, J. Kim, PhD, R. Wolf, MD, K. Lawler, DPhil, D. L. Kolson, MD, PhD and J. A. Detre, MD

From the Department of Neurosciences and Radiology (B.M.A.), University of California at San Diego, San Diego, CA; Departments of Neurology (A.C.R., J.W., M.K., J.K., K.L., D.L.K., J.A.D.) and Radiology (K.K., J.A.D.), Hospital of the University of Pennsylvania, Philadelphia, PA; and Department of Infectious Diseases (J.O., J.S.), Pennsylvania Hospital, Philadelphia, PA.

Address correspondence and reprint requests to Dr. Beau M. Ances, HIV Neurobehavioral Research Center, 150 W. Washington, 2nd Floor, San Diego, CA 92119; e-mail: bances{at}ucsd.edu

Objective: To evaluate the effects of HIV-associated neurocognitive impairment on caudate blood flow and volume.

Methods: The authors performed continuous arterial spin labeled MRI on 42 HIV+ patients (23 subsyndromic and 19 HIV neurosymptomatic) on highly active antiretroviral therapy and 17 seronegative controls. They compared caudate blood flow and volume among groups.

Results: A stepwise decrease in both caudate blood flow and volume was observed with increasing HIV-associated neurocognitive impairment. Compared with seronegative controls, baseline caudate blood flow was reduced in HIV+ neurosymptomatic patients (p = 0.001) with a similar decreasing trend for subsyndromic HIV+ patients (p = 0.070). Differences in caudate volume were observed only for neurosymptomatic HIV+ patients compared with controls (p = 0.010). A Jonckheere–Terpstra test for trends was significant for both caudate blood flow and volume for each of the three subgroups. Pearson product moment correlation coefficients were not significant between caudate blood flow and volume for each group.

Conclusions: Decreasing trends in caudate blood flow and volume were associated with significantly increasing HIV-associated neurocognitive impairment (HNCI), with the greatest decreases observed for more severely impaired patients. However, reductions in caudate blood flow and volume were poorly correlated. Changes in residual caudate blood flow may act as a surrogate biomarker for classifying the degree of HNCI.

* These authors contributed equally to this work.

Supported by a grant at the University of Pennsylvania Center for AIDS Research (B.A., J.D.), Universitywide AIDS Research Program Fellowship (CF05-SD-301) (B.A.), and the University of Pennsylvania AIDS Clinical Trials Unit (NIH AI 32783) (B.A., D.K., J.O., J.S., J.D.).

Disclosure: The authors report no conflicts of interest.

Received August 31, 2005. Accepted in final form November 18, 2005.






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