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1996-02-26
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Document 0449
DOCN M9620449
TI [HIV and dementia: neuropathology]
DT 9602
AU Seilhean D; Duyckaerts C; Hauw JJ; Laboratoire de Neuropathologie R.
Escourolle, Hopital de la; Salpetriere, Paris.
SO J Neuroradiol. 1995 Sep;22(3):161-2. Unique Identifier : AIDSLINE
MED/96043309
AB Cognitive disorders associated with HIV infection may be due to focal
lesions (lymphoma, toxoplasmosis, progressive multifocal
leukoencephalitis, etc.), metabolic encephalopathy (e.g. hepatic
insufficiency) or psychiatric disorders (depression). In the absence of
such causes a cognitive and motor syndrome associated with HIV infection
has been defined on clinical criteria (Working group of the American
Academy of Neurology, 1991). This syndrome is not consistently
associated with any specific lesion. Neither the multifocal encephalitis
of HIV or CMV infection nor the diffuse leukoencephalopathy associated
with HIV are the only causes. The existence of a neocortical neuronal
loss has been suggested by several retrospective studies, but our
prospective study has not shown cortical or subcortical atrophy.
Measurement of neuronal density in Brodmann's areas 4,9 and 40 has not
revealed a significant loss either global, by layer, or by column. The
only constant lesion was gliosis of the cortex and white matter.
Neuronal loss, therefore, is not indispensable to the occurrence of
cognitive disorders in AIDS. The mechanism of dementia might be:
dysfunction of cortical neurons (dendritic abnormalities,
virus/neurotransmitter competition); subcortical dysfunction, as
suggested by the high density of microglial nodules in that region;
white matter lesions which could be due to abnormalities in the
blood-brain barrier. The expression of cell adhesion molecules (VCAM-1,
VLA-4, ICAM-1 and LFA-1) by endothelial cerebral cells is not
significantly different in AIDS patients, demented or not, and in
patients with multiple sclerosis. In contrast, the expression of VCAM-1
by astrocytes is significantly increased in demented AIDS patients
compared with non demented ones.(ABSTRACT TRUNCATED AT 250 WORDS)
DE Atrophy AIDS Dementia Complex/GENETICS/METABOLISM/*PATHOLOGY/PSYCHOLOGY
Blood-Brain Barrier Cell Adhesion Molecules/GENETICS Cerebral
Cortex/PATHOLOGY Comparative Study Cytomegalovirus
Infections/PATHOLOGY Encephalitis, Viral/PATHOLOGY English Abstract
Gene Expression Gliosis/PATHOLOGY Human HIV Infections/PATHOLOGY
Leukoencephalopathy, Progressive Multifocal/PATHOLOGY
Microglia/PATHOLOGY Multiple Sclerosis/GENETICS/METABOLISM
Neurons/PATHOLOGY Prospective Studies Retrospective Studies JOURNAL
ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).