Neuroimaging correlates of HIV-associated BBB compromise

  title={Neuroimaging correlates of HIV-associated BBB compromise},
  author={Malcolm Avison and Avindra Nath and Robin Greene-Avison and Frederick A. Schmitt and Richard N. Greenberg and Joseph R. Berger},
  journal={Journal of Neuroimmunology},

Imaging correlates of the Blood Brain Barrier disruption in HIV associated neurocognitive disorder and therapeutic implications.

This study indicates that HAND in the context of viral suppression is associated withBBB disruption and the DCE MR derived K-trans metric is a very sensitive parameter to identify the BBB disruption.

Biomarkers of HIV-1 CNS infection and injury

Two major avenues are now actively pursued: analysis of soluble molecular markers in CSF and, to a lesser degree, in blood, and neuroimaging markers using anatomic, metabolic, and functional measurements, which consider the rationale and prospects of these approaches.

Combination of HIV-1 and Diabetes Enhances Blood Brain Barrier Injury via Effects on Brain Endothelium and Pericytes

This study demonstrates for the first-time evidence of impaired BBB function in HIV-DM patients and shows potential mechanisms leading to it in brain endothelium and pericytes that may result in poorer cognitive performance compared to individuals without HIV and DM.

Human brain imaging in HIV and neuroAIDS

The purpose of this chapter is to highlight the significance of brain neuroimaging techniques and biomarkers in understanding the pathophysiology related to HIV infection and HAND.

Blood-Brain Barrier Abnormalities Caused by HIV-1 gp120: Mechanistic and Therapeutic Implications

HIV-envelope gp120 disrupts the blood-brain barrier; this occurs via lesions in brain microvessels, MMP activation and degradation of vascular basement membrane and vascular tight junctions; NMDAR-1 activation plays a role in this BBB injury; and antioxidant gene delivery as well as NMDar-1 antagonists may protect the BBB.

Role of Oxidative Stress in HIV-1-Associated Neurocognitive Disorder and Protection by Gene Delivery of Antioxidant Enzymes

The role of oxidative stress in animal models of HIV-1 Associated Neurocognitive Disorder (HAND) and in patients with HAND is reviewed to provide a better understanding of the pathogenesis of HIV -1 in the brain as well as offer new therapeutic avenues.

CSF Penetration by Antiretroviral Drugs

Although a substantial number of studies examined CSF concentrations of antiretroviral drugs, there is a need for adequate, well designed trials to provide more valid drug distribution profiles and for methodological issues to be addressed.

Evolving paradigms in the pathogenesis of HIV-1-associated dementia

Mechanisms for neuronal injury and apoptosis, including the role of virus, viral and host proteins, oxidative stress and products of infected or uninfected activated microglia and astrocytes, are explored.

The imaging of HIV-related brain disease

Earlier treatment with HAART in at-risk or minimally symptomatic patients may prevent further decline in cognition and delay the course of HIV disease.



Metabolic characterization of AIDS dementia complex by spectroscopic imaging

Reduced NAA seems to indicate progressive neuronal injury or loss due to productive HIV infection in the brain and its clinical picture ADC, and may serve as an early quantitative marker of central nervous system involvement in AIDS.

Blood‐brain barrier abnormalities in acquired immunodeficiency syndrome: Immunohistochemical localization of serum proteins in postmortem brain

Results indicate that a diffuse BBB leak is present in approximately 50% of all patients with AIDS at the time of autopsy and may be seen in the absence of any other brain pathology, including HIVE.

Cerebral metabolite abnormalities correlate with clinical severity of HIV-1 cognitive motor complex

In early stages of HIV–CMC, frontal white matter showed evidence of glial proliferation and cell membrane injury, but no significant neuronal injury, while HIV–MCMD and HIV–dementia patients have different neurochemical abnormalities.

Highly active antiretroviral therapy reverses brain metabolite abnormalities in mild HIV dementia

1H MRS detects improvement of brain injury measured by cerebral metabolites, particularly the glial marker [MI], in patients with early HIV-CMC after HAART, in addition to systemic measures of HIV infection.

Abnormal cerebral glucose metabolism in HIV-1 seropositive subjects with and without dementia.

FDG-PET scans provide quantitative measures of abnormal functional connectivity in HIV-seropositives-with or without AIDS or ADC, and appear to track the progression of CNS involvement in patients with subclinical neurologic or neuropsychologic dysfunction.

Elevated subcortical choline metabolites in cognitively and clinically asymptomatic HIV patients

1H MRS imaging detects higher Cho in subcortical brain early in HIV disease, when individuals are clinically and neuropsychologically asymptomatic, whereas lower NAA is only found in sub cORTical brain in individuals with severe neuropsychological impairments.

Patterns of cerebral atrophy in HIV–1–infected individuals

Overall cerebral atrophy and prominent caudate region atrophy are important radiographie features of HIV dementia, and both the VBR and the BCR are significantly associated with dementia.

Neuropathology and neurodegeneration in human immunodeficiency virus infection. Pathogenesis of HIV-induced lesions of the brain, correlations with HIV-associated disorders and modifications according to treatments.

It is concluded that neuronal apoptosis is a late event and does not represent the main pathological substrate of HIVD, and the dementia more likely reflects a specific neuronal dysfunction resulting from the combined effects of several mechanisms, some of which may be reversible.

Intrathecal IgG synthesis and albumin leakage are increased in subjects with HIV-1 neurologic disease.

It is confirmed, using state-of-the-art albumin and IgG determinations, that intrathecal IgG synthesis is prevalent in all stages of HIV-1 disease.