Proton MR spectroscopy of brain abnormalities in neonates born to HIV-positive mothers

AJNR Am J Neuroradiol. 1994 Nov;15(10):1853-9.

Abstract

Purpose: To examine the sensitivity of proton MR spectroscopy for detecting early central nervous system abnormalities in neonates born to human immunodeficiency virus (HIV)-positive mothers.

Methods: Asleep, unsedated, and continuously monitored by electrocardiography, 10 newborns, 5 with HIV-positive and 5 with HIV-negative mothers, were studied within the first 10 days of life in a 1.5-T scanner. After T1- and T2-weighted images were obtained, proton spectra were performed using voxels of interest (3.4 cm3) in the deep parietooccipital white matter. Peaks were identified as N-acetyl-aspartate (2.0 ppm), creatine and phosphocreatine (3.0 ppm), choline (3.2 ppm), and inositol (3.5 ppm). Peak areas were used to calculate metabolic ratios: N-acetyl-aspartate to creatine, inositol to creatine, and creatine to choline.

Results: All newborns of HIV-positive mothers had abnormal proton spectra compared with control infants; a nonspecific amino acid peak in the 2.1- to 2.6-ppm area was elevated, broad, and overlapping the N-acetyl-aspartate peak in all the HIV-exposed newborns and in only 1 of the 5 control newborns. The choline-to-creatine ratio was higher in HIV-exposed newborns at 2.3 +/- 0.4 (normal term, 0.9 +/- 0.3), as was the N-acetyl-aspartate-to-creatine ratio at 2.6 +/- 0.9 (for control subjects, 1.2 +/- 0.4). MR images from these brain regions were all considered normal. Because acquired immunodeficiency syndrome develops in only a small fraction of neonates born to HIV-seropositive mothers, the above spectral abnormalities found in all our subjects may result from indirect effects of HIV, such as intrauterine growth retardation.

Conclusions: These findings indicate that proton MR spectroscopy might play an important role in detecting early central nervous system complications in newborns of HIV-seropositive mothers.

MeSH terms

  • AIDS Dementia Complex / diagnosis*
  • Aspartic Acid / analogs & derivatives
  • Aspartic Acid / metabolism
  • Choline / metabolism
  • Diagnosis, Differential
  • Energy Metabolism / physiology*
  • Female
  • Fetal Growth Retardation / diagnosis
  • HIV Seropositivity / diagnosis*
  • HIV Seropositivity / transmission
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Inositol / metabolism
  • Magnetic Resonance Imaging / methods*
  • Magnetic Resonance Spectroscopy / methods*
  • Male
  • Occipital Lobe / pathology
  • Parietal Lobe / pathology
  • Phosphocreatine / metabolism

Substances

  • Phosphocreatine
  • Aspartic Acid
  • Inositol
  • N-acetylaspartate
  • Choline