A multi-center 1H MRS study of the AIDS dementia complex: Validation and preliminary analysis

Patricia Lani Lee, Constantin T. Yiannoutsos, Thomas Ernst, Linda Chang, Christina M. Marra, Jeffrey G. Jarvik, Todd L. Richards, Edmund W. Kwok, Dennis L. Kolson, David Simpson, Cheuk Y. Tang, Giovanni Schifitto, Leena M. Ketonen, Dieter J. Meyerhoff, Robert E. Lenkinski, R. Gilberto Gonzalez, Bradford A. Navia

Research output: Contribution to journalArticlepeer-review

80 Scopus citations


Purpose: To demonstrate the technical feasibility and reliability of a multi-center study characterizing regional levels of the brain metabolite ratios choline (Cho)/creatine (Cr) and myoinositol (MI)/Cr, markers of glial cell activity, and N-acetyl aspartate (NAA)/Cr, a marker of mature neurons, in subjects with AIDS dementia complex (ADC). Materials and Methods: Using an automated protocol (GE PROBE-P), short echo time spectra (TE = 35 msec) were obtained at eight sites from uniformly prepared phantoms and from three brain regions (frontal white matter, basal ganglia, and parietal cortex) of normal volunteers and ADC and HIV-negative subjects. Results: A random-effects model of the phantom and volunteer data showed no significant inter-site differences. Feasibility of a multi-center study was further validated by detection of significant differences between the metabolite ratios of ADC subjects and HIV-negative controls. ADC subjects exhibited significantly higher Cho/Cr and MI/Cr in the basal ganglia and significantly reduced NAA/Cr and significantly higher MI/Cr in the frontal white matter. These results are consistent with the predominantly subcortical distribution of the pathologic abnormalities associated with ADC. Conclusion: This is the first study to ascertain and validate the reliability and reproducibility of a short echo time 1HMRS acquisition sequence from multiple brain regions in a multi-center setting. It should now be possible to examine the regional effects of HIV infection in the brain in a large number of subjects and to study the metabolic effects of new therapies for the treatment of ADC in a clinical trial setting.

Original languageEnglish (US)
Pages (from-to)625-633
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Issue number6
StatePublished - Jun 1 2003


  • AIDS dementia complex (ADC)
  • HIV infection
  • MRS
  • Neuroimaging
  • Spectroscopy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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