RESUMO
PURPOSE: To evaluate whether human immunodeficiency virus (HIV)-positive patients with and without executive functions deficits and healthy control subjects differ on cortical thickness and subcortical brain structures volume in vivo. METHODS: In total, 34 HIV-positive patients with executive functions deficits were compared with 13 HIV-positive patients without executive functions deficits and 19 gender-, age-, and education-matched control subjects. Executive functions impairments were classified by performance on the Wisconsin card sorting test. T1 3-dimensional magnetization prepared rapid gradient echo-weighted imaging was performed using a 1.5 Tesla (magnetic resonance) MR scanner. FreeSurfer software was used to perform cortical reconstruction and volumetric segmentation of subcortical gray matter structures. RESULTS: HIV-positive patients with executive functions deficits had smaller volumes in the right and left caudate compared with the HIV-positive patients without executive functions deficits and control groups. In addition, HIV-positive patients with executive functions deficits had smaller volumes in their left accumbens, right putamen, and globus pallidum compared with the control group. No significant differences in cortical thickness were observed between the groups. CONCLUSION: HIV-positive patients with executive functions deficits have reduced volumes of several subcortical structures, primarily in the caudate nucleus.
Assuntos
Complexo AIDS Demência/diagnóstico por imagem , Encéfalo/diagnóstico por imagem , Função Executiva/fisiologia , Substância Cinzenta/diagnóstico por imagem , Soropositividade para HIV/diagnóstico por imagem , Imageamento por Ressonância Magnética/métodos , Complexo AIDS Demência/patologia , Adulto , Idoso , Encéfalo/patologia , Brasil , Núcleo Caudado/diagnóstico por imagem , Núcleo Caudado/patologia , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Feminino , Globo Pálido/diagnóstico por imagem , Globo Pálido/patologia , Substância Cinzenta/patologia , Soropositividade para HIV/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Tamanho do Órgão , Putamen/diagnóstico por imagem , Putamen/patologiaRESUMO
OBJECTIVE: To evaluate by Doppler echocardiography (DE) early abnormalities of ventricular function in HIV-positive patients, as well as other cardiac abnormalities that can be detected by this method, with special emphasis on mitral valve flow. METHODS: 84 HIV-positive patients, 59 with CD4 cell count > 500/mm3 (Group A) and 25 with CD4 cell count < 500/mm3 (Group B), were analyzed. CD4 cells were counted and matched with structural data and systolic and diastolic function of the left ventricle (LV), as analyzed by DE. The results were compared with those obtained in 47 healthy individuals (Group C). RESULTS: 8% of patients in Group B had mild pericardial effusion; 31.5% showed decreased systolic function of the LV, and 12% had moderate mitral regurgitation. A wave velocity from the mitral inflow was different among the 3 groups, being higher in Group B, where the deceleration time of the E wave of the mitral inflow and the E/A ratio were significantly lower with a normal value of the isovolumic relaxation time (IVRT). CONCLUSION: HIV-positive patients with a CD4 cell count > 500/mm3 had no abnormalities by DE. Patients with a more advanced infection (those with a CD4 cell count < 500/mm3), had a significantly abnormal LV systolic function and a higher incidence of pericardial effusion and mitral regurgitation. Mitral valve inflow by Doppler did not indicate diastolic dysfunction.