metricas
covid
Buscar en
Revista Colombiana de Psiquiatría
Toda la web
Inicio Revista Colombiana de Psiquiatría Cambios cerebrales en la morfometría en pacientes con VIH
Journal Information
Vol. 41. Issue 3.
Pages 473-484 (September 2012)
Share
Share
Download PDF
More article options
Vol. 41. Issue 3.
Pages 473-484 (September 2012)
Artículos originales
Full text access
Cambios cerebrales en la morfometría en pacientes con VIH
Cerebral Changes in the Morphometrics of HIV Patients
Visits
958
Jorge Andrés Delgado de Bedout1,
Corresponding author
investigacion@iatm.com.co

Correspondencia: Jorge Andrés Delgado de Bedout, Grupo de Investigación Instituto de Alta Tecnología Médica, Carrera 50 No. 63-95, Medellín, Colombia
, Juán Gabriel Castrillón2, Simón Rascovsky3, Lina María García4, Jorge Mario Vélez5, Víctor Daniel Calvo6
1 Director científico del Instituto de Alta Tecnología Médica, Medellín, Colombia
2 Bioingeniero, grupo de investigación del Instituto de Alta Tecnología Médica, Medellín, Colombia
3 Coordinador del grupo de investigación del Instituto de Alta Tecnología Médica, Medellín, Colombia
4 Residente de Radiología, Universidad CES, Medellín, Colombia
5 Médico radiólogo, grupo de investigación del Instituto de Alta Tecnología Médica, Medellín, Colombia
6 Asesor estadístico, grupo de investigación del Instituto de Alta Tecnología Médica, Medellín, Colombia
This item has received
Article information
Resumen

La atrofia cerebral es un hallazgo común en pacientes con infección por el virus de la inmunodeficiencia humana, especialmente en pacientes con demencia; lo que demuestra compromiso neocortical en estadios tardíos de la enfermedad y compromiso de los ganglios basales en las fases tempranas o asintomáticas.

Objetivo

Evaluar los cambios en el volumen cerebral total, el volumen del núcleo caudado, el volumen del núcleo accumbens y la anisotropía fraccional de los tractos de sustancia blanca en pacientes con VIH sin síntomas neurodegenerativos, en relación con sujetos sanos.

Métodos

Para la segmentación y cuantificación del tejido cerebral se extrajo el cerebro y el cráneo; se normalizó de acuerdo con el volumen cerebral total, y a partir de este se segmentaron los volúmenes del núcleo caudado y del núcleo accumbens. Se utilizó el método de tractografía espacial estadística para la cuantificación y búsqueda de diferencias en el coeficiente de anisotropía fraccional.

Resultados

El porcentaje de volumen de sustancia blanca respecto al volumen cerebral fue menor en los pacientes con VIH (42,83 ± 2,65%), comparado con los sujetos sanos (43,56 ± 1,60%). El porcentaje de volumen del núcleo de accumbens izquierdo en los pacientes con VIH fue del 0,0254 ± 0,0073 % del cerebro, y en los individuos sanos, del 0,0351 ± 0,0067% del cerebro; (p < 0,05).

Conclusión

No fue evidente ni significativa la disminución del volumen del parénquima cerebral de la sustancia gris, a excepción del núcleo accumbens izquierdo. En relación con el volumen de la sustancia blanca, se hallaron cambios globales y no regionales en dichos tractos.

Palabras clave:
Morfometría cerebral
anisotropía fraccional
VIH
resonancia magnética
Abstract

Cerebral atrophy is a common finding in patients infected with the Human Immunodeficiency Virus (HIV), particularly in patients with dementia. This disease shows neocortical compromise in late stages as well as compromise in the basal ganglia in early or asyntomatic phases.

Objective

Evaluate changes in total brain volume, caudate nucleus volume, nucleus accumbens volume, and fractional anisotropy of white matter tracts in HIV patients without neurodegenerative symptoms, in comparison with healthy subjects.

Methods

For segmentation and quantification purposes of the brain tissue, the brain and skull were extracted and the tissue was normalized according to total brain volume. From the tissue thus obtained, the caudate nucleus and nucleus accumbens volumes were segmented. The method of statistic spatial tractography was used for quantification and search of differences in the fractional anisotropy coefficient.

Results

The percentage of white matter volume with respect to brain volume was smaller in HIV patients (42.83±2.65 %) when compared with healthy subjects (43.56±1.60 %). The percentage of left nucleus accumbens volume in HIV patients was 0.0254±0.0073 % of the brain and 0.0351±0.0067 % in healthy subjects; (p<0.05).

Conclusions

It was not evident A decrease in the volume of the gray matter parenchyma was not evident or significant, except in the left nucleus accumbens. Global but not regional changes were found in white matter tracts.

Key words:
Brain morphometry
fractional anisotropy
HIV
MRI
Full text is only aviable in PDF
Referencias
[1]
Joint United Nations Programme on HIV/AIDS (UNAIDS).
UNAIDS report on the global AIDS epidemic 2010. Ginebra [internet]. 2011. [citado: 10 de febrero de 2012].
[2]
SP Woods, DJ Moore, E Weber, et al.
Cognitive neuropsychology of HIV-associated neurocognitive disorders.
Neuropsychol Rev, 19 (2009), pp. 152-168
[3]
E Senocak, KK Oğuz, B Ozgen, et al.
Imaging features of CNS involvement in AIDS.
Diagn Interv Radiol, 16 (2010), pp. 193-200
[4]
EJ Singer, M Valdes-Sueiras, D Commins, et al.
Neurologic presentations of AIDS.
Neurol Clin, 28 (2010), pp. 253-275
[5]
JC McArthur, BJ Brew, A Nath.
Neurological complications of HIV infection.
Lancet Neurol, 4 (2005), pp. 543-555
[6]
MC Chiang, RA Dutton, KM Hayashi, et al.
3D pattern of brain atrophy in HIV/AIDS visualized using tensor-based morphometry.
[7]
JC Stout, RJ Ellis, TL Jernigan, et al.
Progressive cerebral volume loss in human immunodeficiency virus infection: a longitudinal volumetric magnetic resonance imaging study. HIV Neurobehavioral Research Center Group.
Arch Neurol, 55 (1998), pp. 161-168
[8]
A Antinori, G Arendt, JT Becker, et al.
Updated research nosology for HIV-associated neurocognitive disorders.
[9]
NC Sacktor, H Bacellar, DR Hoover, et al.
Psychomotor slowing in HIV infection: a predictor of dementia, AIDS and death.
J Neurovirol, 2 (1996), pp. 404-410
[10]
RJ Ellis, DJ Moore, ME Childers, et al.
Progression to neuropsychological impairment in human immunodeficiency virus infection predicted by elevated cerebrospinal fluid levels of human immunodeficiency virus RNA.
Arch Neurol, 59 (2002), pp. 923-928
[11]
Y Stern, MP McDermott, S Albert, et al.
Factors associated with incident human immunodeficiency virus-dementia.
Arch Neurol, 58 (2001), pp. 473-479
[12]
JC McArthur.
HIV dementia: an evolving disease.
J Neuroimmunol, 157 (2004), pp. 3-10
[13]
N Sacktor, RH Lyles, R Skolasky, et al.
HIV-associated neurologic disease incidence changes: multicenter AIDS cohort study, 1990–1998.
Neurology, 56 (2001), pp. 257-260
[14]
SM Smith, Y Zhang, M Jenkinson, et al.
Accurate, robust, and automated longitudinal and cross-sectional brain change analysis.
Neuroimage, 17 (2002), pp. 479-489
[15]
B Patenaude.
Bayesian statistical models of shape and appearance for subcortical brain segmentation. Thesis Doctorate. Oxford centre for functional magnetic resonance imaging of the brain, University of Oxford, (2007),
[16]
SM Smith, M Jenkinson, H Johansen-Berg, et al.
Tract-based spatial statistics: voxel wise analysis of multisubject diffusion data.
Neuroimage, 31 (2006), pp. 1487-1505
[17]
M Descamps, H Hyare, J Stebbing, et al.
Magnetic resonance imaging and spectroscopy of the brain in HIV disease.
J HIV Ther, 13 (2008), pp. 55-58
[18]
SL Archibald, E Masliah, C Fennema-Notestine, et al.
Correlation of in vivo neuroimaging abnormalities with postmortem human immunodeficiency virus encephalitis and dendritic loss.
Arch Neurol, 61 (2004), pp. 369-376
[19]
DF Tate, J Conley, RH Paul, et al.
Quantitative diffusion tensor imaging tractography metrics are associated with cognitive performance among HIV-infected patients.
Brain Imaging Behav, 4 (2010), pp. 68-79
[20]
TL Jernigan, S Archibald, JR Hesselink, et al.
Magnetic resonance imaging morphometric analysis of cerebral volume loss in human immunodeficiency virus infection. The HNRC Group.
Arch Neurol, 50 (1993), pp. 250-255
[21]
K Kieburtz, L Ketonen, C Cox, et al.
Cognitive performance and regional brain volume in human immunodeficiency virus type 1 infection.
Arch Neurol, 53 (1996), pp. 155-158
[22]
EH Aylward, JD Henderer, JC McArthur, et al.
Reduced basal ganglia volume in HIV-1-associated dementia: results from quantitative neuroimaging.
Neurology, 43 (1993), pp. 2099-2104
[23]
SH Patel, DL Kolson, G Glosser, et al.
Correlation between percentage of brain parenchymal volume and neurocognitive performance in HIV-infected patients.
AJNR Am J Neuroradiol, 23 (2002), pp. 543-549
[24]
RH Paul, AM Brickman, B Navia, et al.
Apathy is associated with volume of the nucleus accumbens in patients infected with HIV.
J Neuropsychiatry Clin Neurosci, 17 (2005), pp. 167-171
[25]
DD Blatter, ED Bigler, SD Gale, et al.
Quantitative volumetric analysis of brain MR: normative database spanning 5 decades of life.
AJNR Am J Neuroradiol, 16 (1995), pp. 241-251
[26]
KR Krishnan, MM Husain, WM McDonald, et al.
In vivo stereological assessment of caudate volume in man: effect of normal aging.
Life Sci, 47 (1990), pp. 1325-1329
[27]
M Lauer, D Senitz, H Beckmann.
Increased volume of the nucleus accumbens in schizophrenia.
J Neural Transm, 108 (2001), pp. 645-660
[28]
SJ Van den Bogaard, EM Dumas, TP Acharya, et al.
Early atrophy of pallidum and accumbens nucleus in Huntington's disease.
J Neurol, 258 (2011), pp. 412-420

Conflictos de interés: Los autores manifiestan que no tienen conflictos de interés en este artículo.

Copyright © 2012. Asociación Colombiana de Psiquiatría
Download PDF
Article options