Diagnostic Value Of ~1H MRS In HIV Associated Neurocognitive Disorders

OBJECTIVE:To explore the application value of ¹H MRS in evaluating HIV-related neurocognitive disorders.METHODS:According to the inclusion and exclusion criteria,twenty-six HIV-infected patients who were newly diagnosed and without highly active antiretroviral therapy were collected in Fourth People’s Hospital of Nanning from December 2017 to December 2018.First,the neuropsychological test（NP）was used to divide HIV-infected patients into non-neurocognitive impairment group（UN group,n=9）,asymptomatic neurocognitive impairment-mild neurocognitive disorder group（ANI-MND group,n=5）and HIV-related dementia group（HAD group,n=12）.Second,according to the results of CD4+T lymphocytes count,HIV-infected persons with CD4+T lymphocytes<200/mm3 were regarded as the severe immunodeficiency group（Group A,n=16）whereas HIV-infected persons with CD4+T lymphocytes≥200/mm3 were regarded as non-severe Immunodeficiency group（Group B,n=10）.Simultaneously,16 HIV-negative healthy volunteers with matching age and gender were recruited in this study（Group C）.All subjects were asked to underwent Multi-voxel 1 H-MRS examination on 3.0T MR scanner,then the peaks of NAA,Ch,and Cr in the bilateral frontal gray matter（FGM）and bilateral frontal white matter（FWM）was measured.SPSS 25.0 statistical software was used to compare the differences of NAA/Cr and Ch/Cr between the subgroups of the HIV-infected persons and the normal control group（group C）.RESULTS:Compared with group C,the ratio of NAA/Cr at the left FWM was lower in group ANI-MND and HAD than group C(P_ANI-MND、_C=0.004、P_HAD、_C=0.000),left FWM NAA/Cr was lower in HAD compared with UN(P_HAD、_UN=0.010);Bilateral frontal lobe NAA/Cr was gradually increased in group A,B,C(P _{L-FGM A vs C}=0.006、P _{L-FWM A vs B}=0.026、P _{L-FWM B vs C}=0.025、P _{L-FWM A vs C}=0.000、P _{R-FWM A vs C}=0.036);Left frontal lobe Ch/Cr was gradually decreased in group A,B,C(P _{L-FWM A vs C}=0.018).CONCLUSIONS:NAA/Cr index of the white matter in HIV-infected patients is reduced,and the degree of reduction is related to the stage of HIV-related neurocognitive disorders and the level of CD4+T lymphocytes counts.Therefore,MRS can be used to provide a quantitative reference in diagnosing and evaluating the severity of HIV-related neurocognitive disorders.