Magnetic Resonance Spectroscopy in HIV-Associated Neurocognitive Disorders: HAND

Part of the Contemporary Clinical Neuroscience book series (CCNE)


A significant number of HIV-infected patients develop neurological symptoms ranging from minor cognitive impairment to severe dementia (known HIV-associated dementia, HAD). Without combination antiretroviral therapy (cART) HAD occurs in 20–40 % of HIV positive subjects, with the advent of cART the incident has decreased to 5–10 %, although milder forms of cognitive deficits may occur in 30–50 % of those infected with HIV. It is believed that HIV enters the CNS during the early stages of infection by infected immune cells which initiate an inflammatory cascade which results in neuronal injury and loss. Imaging has been widely used to evaluate the effect of HIV to the brain. Specifically, proton magnetic resonance spectroscopy (1H MRS) is one of the most informative methods employed in patients suffering from HIV-associated neurocognitive disorders (HAND). MRS is able to noninvasively measure metabolic changes pertaining to neuronal injury and inflammation, thus, it can assist in the diagnosis of the disease and measure the severity of injury. In animal models of neuroAIDS, MRS has been proven extremely powerful to assess disease progression and response to treatment. Here we review the literature of preclinical models as well as MRS studies of HIV+ adults and children before and after the advent of cART regiments. In addition, we discuss technical considerations related to the disease and finally talk about future direction in HAND using MRS.


AIDS (acquired immune deficiency syndrome) HIV (Human immunodeficiency Virus) NeuroAIDS HAND (HIV-associated neurocognitive disorders) SIV (Simian immunodeficiency virus) Rhesus Macaque Brain MRS (magnetic resonance spectroscopy) MRSI (magnetic resonance spectroscopic imaging) cART (combination antiretroviral therapy) Minocycline Neuroinflammation 



This work was partly funded by NIH grants R21NS059331, R01NS050041, R01NS040237, R01NS37654, R01MH62962, MH59754, MH62512, RR00168, R24 RR016001, N01 AI040101, and P41RR14075. The author wishes to thank Dr. R Gilberto Gonzalez for valuable discussions.


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Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  1. 1.Department of Radiology, Neuroradiology DivisionMassachusetts General Hospital, Harvard Medical School and Athinuola A. Martinos Center for Biomedical ImagingBostonUSA

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