RESUMO
The purpose of this study was to determine the pattern and extent of caudate nucleus and putamen atrophy in HIV-infected men with well-controlled immune status and viral replication. 155 men underwent structural brain magnetic resonance imaging; 84 were HIV-infected and 71 were uninfected controls. MRI data were processed using the Fully Deformable Segmentation routine, producing volumes for the right and left caudate nucleus and putamen, and 3-D maps of spatial patterns of thickness. There was significant atrophy in the HIV-infected men in both the caudate and putamen, principally in the anterior regions. The volume of the basal ganglia was inversely associated with the time since first seropositivity, suggesting that either there is a chronic, subclinical process that continues in spite of therapy, or that the extent of the initial insult caused the extent of atrophy.
Assuntos
Terapia Antirretroviral de Alta Atividade , Núcleo Caudado/patologia , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Imageamento por Ressonância Magnética , Putamen/patologia , Algoritmos , Atrofia , Estudos de Coortes , Humanos , Processamento de Imagem Assistida por Computador , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Fatores de TempoRESUMO
Ideal biomarkers of Alzheimer's disease (AD) should correlate with accepted measures of pathology in the cerebrospinal fluid (CSF); they should also correlate with, or predict, future clinical decline, and should be readily measured in hundreds to thousands of subjects. Here we explored the utility of automated 3D maps of the lateral ventricles as a possible biomarker of AD. We used our multi-atlas fluid image alignment (MAFIA) method, to compute ventricular models automatically, without user intervention, from 804 brain MRI scans with 184 AD, 391 mild cognitive impairment (MCI), and 229 healthy elderly controls (446 men, 338 women; age: 75.50 +/- 6.81 [SD] years). Radial expansion of the ventricles, computed pointwise, was strongly correlated with current cognition, depression ratings, Hachinski Ischemic scores, language scores, and with future clinical decline after controlling for any effects of age, gender, and educational level. In statistical maps ranked by effect sizes, ventricular differences were highly correlated with CSF measures of Abeta(1-42), and correlated with ApoE4 genotype. These statistical maps are highly automated, and offer a promising biomarker of AD for large-scale studies.
