Hostname: page-component-586b7cd67f-2brh9 Total loading time: 0 Render date: 2024-11-25T21:18:31.776Z Has data issue: false hasContentIssue false

Hepatitis C virus infection is associated with reduced white matter N-acetylaspartate in abstinent methamphetamine users

Published online by Cambridge University Press:  06 February 2004

MICHAEL J. TAYLOR
Affiliation:
University of California, San Diego, San Diego, California VA San Diego Healthcare System, San Diego, California
SCOTT L. LETENDRE
Affiliation:
University of California, San Diego, San Diego, California
BRIAN C. SCHWEINSBURG
Affiliation:
University of California, San Diego, San Diego, California VA San Diego Healthcare System, San Diego, California SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California
OMAR M. ALHASSOON
Affiliation:
University of California, San Diego, San Diego, California VA San Diego Healthcare System, San Diego, California SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California
GREGORY G. BROWN
Affiliation:
University of California, San Diego, San Diego, California VA San Diego Healthcare System, San Diego, California
ASSAWIN GONGVATANA
Affiliation:
University of California, San Diego, San Diego, California VA San Diego Healthcare System, San Diego, California SDSU/UCSD Joint Doctoral Program in Clinical Psychology, San Diego, California
IGOR GRANT
Affiliation:
University of California, San Diego, San Diego, California VA San Diego Healthcare System, San Diego, California
THE HNRC
Affiliation:
University of California, San Diego, San Diego, California

Extract

Nearly 3,000,000 people in the United States, and over 100,000,000 people worldwide, are infected with hepatitis C virus (HCV), with an increasing trajectory for the foreseeable future (Alter et al., 1999). While hepatic encephalopathy has been long recognized as a disorder associated with cerebral structural, metabolic, and cognitive changes (e.g., Tarter et al., 1989), HCV infection itself is increasingly associated with changes in the brain, even in the absence of hyperammonemia. Specifically, HCV-infected individuals may have deficits in cognitive functions such as attention, working memory, and speed of information processing (Forton et al., 2002; Hilsabeck et al., 2002). They may also have abnormalities on magnetic resonance spectroscopy (MRS), a non-invasive method to measure cerebral metabolites. The most reliably measured compounds using a standard 1.5 Tesla MRI scanner are N-acetylaspartate (NAA), a marker of neuronal integrity; choline and choline-containing compounds (Cho), a measure of cell membrane turnover and lipid changes; myo-Inositol (Ins), a possible indicator of glial proliferation and/or osmolar changes; and creatine+phosphocreatine (Cr), an indicator of high energy stores that is often used as a relative standard for other metabolites. In the first studies of HCV using MRS, Forton et al. (2001; 2002) found elevated Cho/Cr in the frontal white matter and basal ganglia in patients with HCV. In addition patients with two or more impaired neuropsychological test performances had higher Cho/Cr compared to those with less than two impaired test performances.Dr. Erin D. Bigler served as Action Editor during the course of this review.

Type
RESEARCH LETTER
Copyright
© 2004 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Alter, M.J., Kruszon-Moran, D., Nainan, O.V., McQuillan, G.M., Gao, F., Moyer, L.A., Kaslow, R.A., & Margolis, H.S. (1999). The prevalence of hepatitis C infection in the United States, 1988 through 1994. New England Journal of Medicine, 341, 556562.Google Scholar
Caussin-Schwemling, C., Schmitt, C., & Stoll-Keller, F. (2001). Study of the infection of human blood derived monocyte/macrophages with hepatitis C virus in vitro. Journal of Medical Virology, 65, 1422.Google Scholar
Davidson, C., Gow, A.J., Lee, T.H., & Ellinwood, E.H. (2001). Methamphetamine neurotoxicity: Necrotic and apoptotic mechanisms and relevance to human abuse and treatment. Brain Research, 36, 122.Google Scholar
Ernst, T., Chang, L., Leonido-Yee, M., & Speck O. (2000). Evidence for long-term neurotoxicity associated with methamphetamine abuse: A 1H MRS study. Neurology, 54, 13441349.Google Scholar
Forton, D.M., Allsop, J.M., Main, J., Foster, G.R., Thomas, H.C., & Taylor-Robinson, S.D. (2001). Evidence for a cerebral effect of the hepatitis C virus. Lancet, 358, 3839.Google Scholar
Forton, D.M., Thomas, H.C., Murphy, C.A., Allsop, J.M., Foster, G.R., Main, J., Wesnes, K.A., & Taylor-Robinson, S.D. (2002). Hepatitis C and cognitive impairment in a cohort of patients with mild liver disease. Hepatology, 35, 433439.Google Scholar
Heaton, R.K., Grant, I., Butters, N., White, D.A., Kirson, D., Atkinson, J.H., McCutchan, J.A., Taylor, M., Kelly, M.D., Ellis, R.J., Wolfson, T., Velin, R., Marcotte, T.D., Hesselink, J.R., Jernigan, T.L., Chandler, J., Wallace, M., Abramson, I., and the HNRC Group. (1995). The HNRC 500—neuropsychology of HIV infection at different disease stages. Journal of the International Neuropsychological Society, 1, 231251.Google Scholar
Hilsabeck, R.C., Perry, W., & Hassanein, T.I. (2002). Neuropsychological impairment in patients with chronic hepatitis C. Hepatology, 35, 440446.Google Scholar
Kramer, L., Bauer, E., Funk, G., Hofer, H., Jessner, W., Steindl-Munda, P., Wrba, F., Madl, C., Gangl, A., & Ferenci, P. (2002). Subclinical impairment of brain function in chronic hepatitis C infection. Journal of Hepatology, 37, 349354.Google Scholar
Provencher, S.W. (1993). Estimation of metabolite concentrations from localized in vivo proton NMR spectra. Magnetic Resonance in Medicine, 30, 672679.Google Scholar
Rippeth, J.D., Heaton, R.K., Carey, C.L., Marcotte, T.D., Moore, D.J., Gonzalez, R., Wolfson, T., & Grant, I. (2004). Methamphetamine dependence increases risk of neuropsychological impairment in HIV infected persons. Journal of the International Neuropsychological Society (this issue), 114.Google Scholar
Robbins, L.N. & Regier, D.A. (Eds.). (1991). Psychiatric disorders in America. New York: The Free Press.
Schweinsburg, B.C., Taylor, M.J., Videen, J.S., Alhassoon, O.M., Patterson, T.L., & Grant I. (2000). Elevated myo-inositol in gray matter of recently detoxified but not long-term abstinent alcoholics: A preliminary MR spectroscopy study. Alcoholism Clinical and Experimental Research, 24, 699705.Google Scholar
Tarter, R.E., Edwards, K.L., & Van Thiel, D.H. (1989). Neuropsychological dysfunction due to liver disease. In R.E. Tarter, D.H. Van Thiel, & K.L. Edwards (Eds.), Medical neuropsychology (pp. 7597). New York: Plenum Press.