Abstract

To investigate the relationship between cognitive impairment and hippocampal morphological and functional changes in HIV-seropositive patients. Thirty HIV+ patients who complain of memory decrease and 15 healthy volunteers were recruited. Performances of learning and memory were assessed using Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R). Bilateral hippocampal volume, apparent diffusion coefficient (ADC) value, fractional anisotropy value, and magnetic resonance spectroscopy variables of bilateral hippocampus and parahippocampal gyrus were detected by 3.0 T magnetic resonance scanner. We found significant differences in all cognitive outcomes but one between HIV+ and HIV- patients. There was a difference in the ADC value of left parahippocampal gyrus between mild-impairment group and severe-impairment group (P = 0.018). We found differences in the choline (Cho), Cho/creatinine (Cr), and N-acetylaspartate/Cr of left hippocampus (P = 0.002, P = 0.008, P = 0.002) and the Cho/Cr of right parahippocampal gyrus (P = 0.023) between HIV+ and HIV- patients and in the myoinositol of left hippocampus (P = 0.003) and the glutamate and glutamine of right hippocampus (P < 0.001) between mild-impairment group and severe-impairment group. We found significant positive correlations between N-acetylaspartate/Cr of left hippocampus and outcomes of HVLT-R and BVMT-R. There were significant negative correlations between ADC values of hippocampus and parahippocampal gyrus and outcomes of HVLT-R and BVMT-R and between Cho and Cho/Cr of hippocampus and parahippocampal gyrus and outcomes of HVLT-R and BVMT-R. The performance of verbal learning and visual memory was significantly decreased in HIV-1-seropositive patients. The cognitive impairment of HIV infection was associated with conductive function and metabolic changes of hippocampus and parahippocampal gyrus in this study.

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