Transcranial sonography of the third ventricle and cognitive dysfunction in HIV patients.

BACKGROUND

Although the incidence and prevalence of dementia associated with human immunodeficiency virus (HIV) infection has decreased since the introduction of highly active antiretroviral therapy, cognitive dysfunction remains one of the most prevalent factors severely affecting quality of life in patients with HIV. Previous magnetic resonance imaging (MRI) studies showed a correlation between brain atrophy, enlargement of the ventricles and cognitive impairment in HIV patients.

OBJECTIVE

To investigate the usefulness of transcranial sonographic (TCS) measurement of the third ventricle in detection of brain atrophy in HIV patients and the correlation with neuropsychological deficits.

METHODS

We examined 47 HIV patients and 40 healthy age-matched controls with TCS, neuroimaging (cranial MRI or computed tomography) and a neuropsychological test battery.

RESULTS

The third ventricle was significantly larger in patients than in healthy controls and correlated significantly with duration of HIV, Center of Disease Control (CDC) stage, CD4 lymphocytes and distinct cognitive and motor deficits.

CONCLUSION

TCS cannot replace neuroimaging but is a valuable method in the detection of brain atrophy and follow-up of HIV patients at risk or with a recent diagnosis of HIV encephalopathy.