A multi-center 1H MRS study of the AIDS dementia complex: validation and preliminary analysis.

Abstract

PURPOSE:

To demonstrate the technical feasibility and reliability of a multi-center study characterizing regional levels of the brain metabolite ratios choline (Cho)/creatine (Cr) and myoinositol (MI)/Cr, markers of glial cell activity, and N-acetyl aspartate (NAA)/Cr, a marker of mature neurons, in subjects with AIDS dementia complex (ADC).

MATERIALS AND METHODS:

Using an automated protocol (GE PROBE-P), short echo time spectra (TE = 35 msec) were obtained at eight sites from uniformly prepared phantoms and from three brain regions (frontal white matter, basal ganglia, and parietal cortex) of normal volunteers and ADC and HIV-negative subjects.

RESULTS:

A random-effects model of the phantom and volunteer data showed no significant inter-site differences. Feasibility of a multi-center study was further validated by detection of significant differences between the metabolite ratios of ADC subjects and HIV-negative controls. ADC subjects exhibited significantly higher Cho/Cr and MI/Cr in the basal ganglia and significantly reduced NAA/Cr and significantly higher MI/Cr in the frontal white matter. These results are consistent with the predominantly subcortical distribution of the pathologic abnormalities associated with ADC.

CONCLUSION:

This is the first study to ascertain and validate the reliability and reproducibility of a short echo time (1)H-MRS acquisition sequence from multiple brain regions in a multi-center setting. It should now be possible to examine the regional effects of HIV infection in the brain in a large number of subjects and to study the metabolic effects of new therapies for the treatment of ADC in a clinical trial setting.

• Authors: Patricia Lani Lee, Constantin T Yiannoutsos, Thomas Ernst, Linda Chang, Christina M Marra, Jeffrey G Jarvik, Todd L Richards, Edmund W Kwok, Dennis L Kolson, David Simpson, Cheuk Y Tang, Giovanni Schifitto, Leena M Ketonen, Dieter J Meyerhoff, Robert E Lenkinski, R Gilberto Gonzalez, Bradford A Navia, HIV MRS Consortium
• Journal: Journal of magnetic resonance imaging : JMRI (J Magn Reson Imaging) Vol. 17 Issue 6 Pg. 625-33 (Jun 2003) ISSN: 1053-1807 [Print] United States
• PMID: 12766890 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S., Validation Study)
• Copyright: Copyright 2003 Wiley-Liss, Inc.

Chemical References

• Excitatory Amino Acid Antagonists
• Aspartic Acid
• Inositol
• Hydrogen
• N-acetylaspartate
• Creatine
• Choline
• Memantine

Topics

• AIDS Dementia Complex (diagnosis, drug therapy, metabolism)
• Analysis of Variance
• Aspartic Acid (analogs & derivatives, metabolism)
• Brain (metabolism, pathology)
• Choline (metabolism)
• Creatine (metabolism)
• Excitatory Amino Acid Antagonists (administration & dosage)
• Feasibility Studies
• Humans
• Hydrogen
• Inositol (metabolism)
• Magnetic Resonance Spectroscopy (instrumentation)
• Memantine (administration & dosage)
• Neuroglia (metabolism)
• Phantoms, Imaging
• Reproducibility of Results