RESUMEN
PURPOSE: Changes in cerebral cortical regions occur in HIV-infected patients, even in those with mild neurocognitive disorders. Working memory / attention is one of the most affected cognitive domain in these patients, worsening their quality of life. Our objective was to assess whether cortical thickness differs between HIV-infected patients with and without working memory deficit. METHODS: Forty-one adult HIV-infected patients with and without working memory deficit were imaged on a 1.5 T scanner. Working memory deficit was classified by composite Z scores for performance on the Digits and Letter-Number Sequencing subtests of the Wechsler Adult Intelligence Scale (third edition; WAIS-III). Cortical thickness was determined using FreeSurfer software. Differences in mean cortical thickness between groups, corrected for multiple comparisons using Monte-Carlo simulation, were examined using the query design estimate contrast tool of the FreeSurfer software. RESULTS: Greater cortical thickness in left pars opercularis of the inferior frontal gyrus, and rostral and caudal portions of the left middle frontal gyrus (cluster 1; p = .004), and left superior frontal gyrus (cluster 2; p = .004) was observed in HIV-infected patients with working memory deficit compared with those without such deficit. Negative correlations were found between WAIS-III-based Z scores and cortical thickness in the two clusters (cluster 1: ρ = -0.59; cluster 2: ρ = -0.47). CONCLUSION: HIV-infected patients with working memory deficit have regions of greater thickness in the left frontal cortices compared with those without such deficit, which may reflect increased synaptic contacts and/or an inflammatory response related to the damage caused by HIV infection.
Asunto(s)
Corteza Cerebral/patología , Corteza Cerebral/virología , Infecciones por VIH/patología , Trastornos de la Memoria/virología , Memoria a Corto Plazo/fisiología , Adulto , Anciano , Brasil/epidemiología , Femenino , VIH/aislamiento & purificación , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Infecciones por VIH/virología , Humanos , Masculino , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/patología , Trastornos de la Memoria/psicología , Persona de Mediana Edad , Pruebas NeuropsicológicasRESUMEN
Craniopharyngeal canal persistence is a congenital abnormality characterized by a bone canal extending from the nasopharynx to the pituitary fossa. Ascension of microorganisms through the channel can occur, triggering meningitis.
Asunto(s)
Absceso/diagnóstico por imagen , Espina Bífida Oculta/diagnóstico por imagen , Enfermedades de la Médula Espinal/diagnóstico por imagen , Absceso/complicaciones , Femenino , Humanos , Lactante , Imagen por Resonancia Magnética , Espina Bífida Oculta/complicaciones , Enfermedades de la Médula Espinal/complicacionesRESUMEN
INTRODUCTION: The aim of this study was to evaluate whether normal controls and human immunodeficiency virus (HIV) patients with and without planning deficits differ on white matter integrity. METHODS: A total of 34 HIV-positive patients with planning deficits were compared with 13 HIV-positive patients without planning deficits and 19 gender-, age-, and education-matched control subjects. Diffusion tensor imaging (DTI) was performed along 30 noncolinear directions in a 1.5-T scanner. For tract-based spatial statistics analysis, a white matter skeleton was created, and a permutation-based inference with 5000 permutations with a threshold of p < 0.05 was used to identify abnormalities in fractional anisotropy (FA). The median, radial, and axial diffusivities were also projected onto the mean FA skeleton. RESULTS: Compared with controls, HIV-positive patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu and splenium of the corpus callosum, bilateral superior longitudinal fascicule, and bilateral uncinate fasciculi. Compared to HIV-positive patients without planning deficits, patients with planning deficits had decreased FA in bilateral anterior thalamic radiations, bilateral inferior fronto-occiptal fasciculi, genu of the corpus callosum, bilateral superior longitudinal fascicule, and right uncinate fascicule. CONCLUSION: DTI can detect extensive white matter abnormalities in the normal-appearing white matter of HIV-positive patients with planning deficits compared with controls and HIV-positive patients without planning deficits.