Advances in neuroimaging for HIV-1 associated neurological dysfunction: Clues to the diagnosis, pathogenesis and therapeutic monitoring

Michael D. Boska, R. Lee Mosley, Mehmood Nawab, Jay A. Nelson, Marina Zelivyanskaya, Larisa Poluektova, Mariano Uberti, Huanyu Dou, Travis B. Lewis, Howard E. Gendelman

Research output: Contribution to journalReview articlepeer-review

32 Scopus citations

Abstract

Persons with advanced human immunodeficiency virus type one (HIV-1) infection seek medical advice for a wide range of neurological disorders including, but not limited to, peripheral neuropathy, toxoplasmosis, cryptococcal meningitis, cytomegalovirus retinitis progressive multifocal leukoencephalopathy, lymphoma and dementia. The diagnosis of HIV-1-associated dementia (HAD) induced as a direct consequence of HIV infection of the brain comes commonly by exclusion. Diagnostic decisions can often be clouded by concomitant depression, motor impairments, and lethargy that follow debilitating immune suppression and weight loss. Indeed, cognitive, motor and behavior abnormalities underlie a variety of neurological dysfunctions associated with advanced HIV-1 infection. Thus, even combinations of clinical, laboratory and neuroimaging tests [for example, magnetic resonance imaging (MRI), computed tomography (CT), single photon emission computed tomography (SPECT) and positron emission tomography (PET)] often fail to provide conclusive diagnostic information. Nonetheless, the recent development of quantitative MR spectroscopic imaging has improved diagnostic possibilities for HAD. We are pleased to discuss these developments as well as taking a forward look into what will soon be made available to improve neuroimaging diagnostic precision. New MR and SPECT testing are being developed in our laboratories and elsewhere both for animal model systems and in humans with HIV-1 disease. Such tests can facilitate dynamic measures of HIV-1 neuropathogenesis providing information for disease events that even 2 years ago were unattainable.

Original languageEnglish (US)
Pages (from-to)61-78
Number of pages18
JournalCurrent HIV research
Volume2
Issue number1
DOIs
StatePublished - Jan 2004

Keywords

  • Cognitive dysfunction
  • HAD
  • HIV-1 encephalitis
  • HIV-1-associated dementia
  • HIVE
  • MRI
  • MRS
  • Magnetic resonance imaging
  • Magnetic resonance spectroscopy
  • Mononuclear phagocytes
  • SPECT
  • Single photon emission computed tomography

ASJC Scopus subject areas

  • Infectious Diseases
  • Virology

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