Progressive brain atrophy in HIV/AIDS is associated with impaired psychomotor performance, perhaps partly reflecting cerebellar degeneration; yet little is known about how HIV/AIDS affects the cerebellum. We visualized the three-dimensional profile of atrophy in 19 HIV-positive patients (age: 42.9±8.3 years) versus 15 healthy controls (age: 38.5±12.0 years). We localized consistent patterns of subregional atrophy with an image analysis method that automatically deforms each patient's scan, in three dimensions, to match a reference image. Atrophy was greatest in the posterior cerebellar vermis (14.9% deficit) and correlated with depression severity (P=0.009, corrected), but not with dementia, alcohol/substance abuse, CD4+T-cell counts, or viral load. Profound cerebellar deficits in HIV/AIDS (P=0.007, corrected) were associated with depression, suggesting a surrogate disease marker for antiretroviral trials.

Expansion of the cerebral ventricles may occur at an accelerated rate in subjects with dementia, but the time course of expansion during transitions between normal cognitive function, mild cognitive impairment (MCI), and dementia is not well understood. Furthermore, the effects of cardiovascular risk factors on rate of ventricular expansion are unclear. We used a fully automated segmentation technique to measure change rate in lateral ventricle-to-brain ratio (VBR) on 145 longitudinal pairs of magnetic resonance images of subjects in the Cardiovascular Health Study Cognition Study from the Pittsburgh Center. A multivariate model analyzed VBR change rate, accounting for dementia statuses at both imaging times (normal, MCI, or dementia), age, sex, education, race, magnetic resonance-defined infarcts, Center for Epidemiology Studies Depression Scale, baseline ventricular volume, and cardiovascular risk factors. VBR change was faster in subjects who were demented or transitioned from MCI to dementia, compared with subjects normal at both images and subjects who transitioned from normal to MCI or dementia. Patients with diabetes had faster VBR change. Ventricular expansion may accelerate late in the progression from normal cognitive function to dementia, and may be modulated by diabetes.

Elevated cerebral ventricular volume may be associated with dementia risk and progression. A fully-automated technique that agreed highly with radiological readings was used to estimate lateral ventricle volume on MR scans done at baseline in 1997-99 of 377 subjects in the Cardiovascular Health Study (CHS) from the Pittsburgh Center. 327 subjects were normal or diagnosed with mild cognitive impairment (MCI) at baseline and were evaluated 4 years later. Baseline ventricular volume was analyzed in multivariate models with age, gender, education level, presence and incidence of cerebral infarcts, and dementia category (normal, MCI, or dementia) at baseline and follow-up as fixed effects. Ventricular volume at baseline was significantly higher among subjects normal at baseline and demented 4 years later. Age, gender, education level, and dementia progression were significant factors affecting ventricular volume. Ventricular volume was higher in dementia compared to MCI, higher in MCI compared to controls, and higher in Possible-Alzheimer's-disease (AD) dementia compared to Probable-AD. Larger ventricles in healthy subjects may indicate susceptibility to, or progression of, dementia-related pathology. (c) 2006 Elsevier Inc. All rights reserved.

OBJECTIVE:40 million people worldwide are now infected with HIV/AIDS, an illness that often leads to rapidly progressing dementia and death. Even so, little is known about how AIDS affects the brain. Using computational anatomy techniques, we mapped how AIDS impacts the corpus callosum (CC) and ventricular system, two systems that show prominent changes on MRI. We (1) identified regions with greatest differences between AIDS patients and healthy controls and (2) correlated specific 3D patterns of structural differences with measures of immune system deterioration and cognitive decline. METHODS:51 3D brain MRI scans from 30 non-demented AIDS patients (age: 43.4 years +/- 7.6 SD) and 21 HIV-seronegative controls (age: 39.5 years +/- 12.2) were aligned to ICBM standard space. 3D surface mesh reconstructions of the lateral ventricles and CC were spatially averaged and compared across diagnostic groups. Structural alterations were correlated with viral load, T cell counts, and cognitive impairment. RESULTS:Statistical maps revealed the 3D profile of ventricular expansion and callosal thinning in AIDS. Specific 3D ventricular changes were linked with immune system decline (CD4+ T cell counts; P < 0.001) and cognitive impairment (P < 0.009), but not viral load. Frontal horn maps distinguished AIDS patients from controls better than occipital and temporal horn measures. T cell decline linked with callosal thinning in anterior regions connecting frontal areas with greatest cortical atrophy. CONCLUSION:These maps (1) reveal how brain changes in HIV/AIDS relate to immune decline and impaired cognition, and, after further validation and testing, (2) may offer possible neuroimaging markers for anti-viral drug trials, which gauge how well treatments oppose disease progression in the brain.

Pediatric PulmonologyVolume 5, Issue 1 p. 62-62 Book Review Anesthesia and uncommon pediatric diseases. Edited by Jordan Katz and David J. Steward. Philadelphia: W.B. Saunders Co., 1987 Sharon E. Lee MD, Sharon E. Lee MD Division of Pediatric Intensive Care Childrens Hospital of Los Angeles Los Angeles, CaliforniaSearch for more papers by this authorChristopher J. L. Newth MB, Frcp(C), Christopher J. L. Newth MB, Frcp(C) Division of Pediatric Intensive Care Childrens Hospital of Los Angeles Los Angeles, CaliforniaSearch for more papers by this author Sharon E. Lee MD, Sharon E. Lee MD Division of Pediatric Intensive Care Childrens Hospital of Los Angeles Los Angeles, CaliforniaSearch for more papers by this authorChristopher J. L. Newth MB, Frcp(C), Christopher J. L. Newth MB, Frcp(C) Division of Pediatric Intensive Care Childrens Hospital of Los Angeles Los Angeles, CaliforniaSearch for more papers by this author First published: 1988 https://doi.org/10.1002/ppul.1950050113AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume5, Issue11988Pages 62-62 RelatedInformation

We present a fully-automated technique for visualizing localized cerebral ventricle shape differences between large clinical subject groups who have received a magnetic resonance (MR) image scan. The technique combines a robust, automated technique for ventricular segmentation with a 3D surface-based radial thickness mapping approach that allows spatially-localized statistical tests of relative shape differences between clinical groups. The technique is used to analyze localized ventricular expansion in Alzheimer's disease (AD) and mild cognitive impairment (MCI) in a large cohort of community-dwelling elderly individuals (N=339). The resulting maps are the first to chart localized ventricular dilation in a cohort of this size. Besides showing patterns of ventricular expansion that may be consistent with the spatial progression of AD-related pathology, the maps reveal new information about localized ventricular atrophy that may have been overlooked to date. A detailed understanding of spatial atrophy patterns may be useful for early disease detection or for patient monitoring in drug trials