final program.qxd - Parallels Plesk Panel
final program.qxd - Parallels Plesk Panel
final program.qxd - Parallels Plesk Panel
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PP 3.16<br />
Neurophysiological and neurometabolic characteristics of patients under HAART<br />
with cognitive complaint.<br />
Frixon-Marin V*(1)., Poizot-Martin I.*, Drogoul M.P*, Michotey P.** Gastaut J.A*.<br />
and Vion-Dury J***.<br />
*CISIH, CHU Ste Marguerite, ** : Department of Radiology, Hôpital Ambroise Paré, ***<br />
Service de Neurophysiologie Clinique, CHU Conception ; Marseille France<br />
About 20-40% of HIV patients under HAART display cognitive troubles, affecting mainly<br />
memory and attention. Neurophysiological and neurochemical status have been<br />
evaluated in 35 patients (27 males and 8 females), presenting a cognitive complaint, using<br />
respectively: a) P300 cognitive evoked potentials (acoustic oddball paradigm) and<br />
standard EEG, and b) brain proton magnetic resonance imaging (MRI) and spectroscopy<br />
(MRS; PRESS sequence, TE 135 ms, TR 1500ms. NAA/Cho, NAA/Cr and Cho/Cr<br />
metabolic ratios analyzed.) At the time of examination, 22 patients presented an<br />
undetectable blood viral load, and 8 a viral load 400 = x =10000.<br />
Twenty patients (57%) display an abnormal EEG, mainly characterized by vascular signs<br />
abnormal for age (alpha waves diffusing in frontal areas, sharp slow waves….). EEG is<br />
always abnormal in the 8 patients with a low (< 200) blood CD4 count.<br />
Twelve patients (34%) display an abnormal P300 (increase in P3B latency for age).<br />
P300 is found significantly more frequently abnormal in patients with CD4 < 200, than in<br />
patients with CD4 > 200 (p = 0.05, chi2 test).<br />
MRI is normal in only 10 patients (29%). Non specific WM abnormalities and/or a atrophy<br />
(cortical or sub-cortical) are the most frequent abnormalities.<br />
MRS is abnormal (2 of 4 recorded spectra with one abnormal metabolic ratio) in 22 (62 %)<br />
patients.<br />
Cognitive troubles in HIV patients under HAART are accompanied by both<br />
neurophysiological and neurochemical significant abnormalities suggesting that they are<br />
clearly from an organic origin. The viral and/or iatrogenic cause of such abnormalities<br />
remains to be precised. Neurophysiology and MRI features are compatible with the<br />
hypothesis of a premature ageing.<br />
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