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Journal of Child Neurology
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Clinical and Imaging Study of Human Immunodeficiency Virus-1—Infected Youth Receiving Highly Active Antiretroviral Therapy: Pilot Study Using Magnetic Resonance Spectroscopy

Lidia Gabis, MD

Child Development Center, Safra Children's Hospital, Tel Hashomer, Israel, gabis{at}post.tau.ac.il

Anita Belman, MD

Department of Neurology, Stony Brook University, Stony, Brook, NY

Wei Huang, PhD

Department of Radiology, Stony Brook University, Stony, Brook, NY

Maria Milazzo, RNP

Department of Neurology, Stony Brook University, Stony, Brook, NY

Sharon Nachman, MD

Department of Pediatrics, Stony Brook University, tony, Brook, NY

The objective of this study was to correlate clinical and neuropsychologic findings with neuroimaging studies to assess the value of magnetic resonance spectroscopy in detection and monitoring of central nervous system disease of children vertically infected with human immunodeficiency virus (HIV)-1 and receiving highly active antiretroviral therapy. Eight children (four boys) with vertically transmitted stable HIV infection had a neurologic examination, neuropsychologic testing, and a neuroimaging study. The structural magnetic resonance imaging (MRI) and metabolic changes (magnetic resonance spectroscopy) were compared with the cognitive, clinical, and laboratory results. Our results for the eight children who completed the magnetic resonance spectroscopic study showed that a high N-acetylaspartate (NAA) to choline ratio correlated significantly with IQ subtests of arithmetic (r = .74; P < .034) and comprehension (r = .77; P = .025). Our results suggest that lower NAA and higher choline values represent neuronal dysfunction and inflammation that can be recognized before anatomic changes appear on MRI. In addition, a low NAA to Cho ratio correlated with poor performance. These data suggest that magnetic resonance spectroscopy can be used as a follow-up tool in addition to the structural MRI. Moreover, a change in a child's performance with a concomitant change in NAA and choline, as measured with magnetic resonance spectroscopy, could indicate the need for more aggressive intervention. (J Child Neurol 2006;21:485—490; DOI 10.2310/7010.2006.00126).

Journal of Child Neurology, Vol. 21, No. 6, 485-490 (2006)
DOI: 10.1177/08830738060210061801
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