HIV infection often results in MRI-detectable brain
atrophy and white matter signal hyperintensities (WMSHs).
Magnetic resonance images were obtained from 31 HIV+ male
patients and 10 high-risk controls. Variation within the
HIV+ group on neuropsychological (NP) impairment and stage
of systemic disease were relatively independent, allowing
examination of the relative association of MRI measures
with NP impairment versus with systemic stage
of disease. HIV+ patients compared to high-risk controls
evidenced global atrophy, reduced caudate nuclei volume,
and a trend to gray matter volume loss but no difference
in white matter volume or in WMSHs. These effects were
progressive with CDC clinical stage such that patients
at CDC stage A had values very close to those of controls,
while patients at CDC stage C had the most abnormal values.
In contrast, the relationship between these MRI variables
and severity of NP impairment was much less dramatic, with
the mildly to moderately impaired HIV+ subjects showing
MRI volume effects greater than or equal to those of the
severely impaired HIV+ subjects. These results suggest
that MRI-detectable brain atrophy secondary to HIV infection
is not the primary substrate underlying the progressive
NP impairment in HIV disease. (JINS, 1997, 3,
276–287.)