BACKGROUND/AIMS: Abnormal cerebral metabolism and cognitive impairments have been reported in patients with chronic hepatitis C (HCV) but studies have failed to demonstrate a relationship between these findings. METHODS: Twenty-five HCV-positive patients with histologically-mild liver disease were studied with cerebral proton magnetic resonance spectroscopy (MRS), using acquisition parameters to quantify myo-inositol (mI) and other metabolites in frontal white matter (FWM). Patients underwent automated attention and working memory tests (Cognitive Drug Research test system). RESULTS: The mean mI/ creatine ratio in the HCV+ve patients (0.64, SD 0.21) was significantly higher (p=0.02) than in healthy controls (0.52, SD 0.10). On cognitive testing, the HCV+ve patients showed impairments in 2/4 composite scores, reflecting working memory and attention, compared to normative data from healthy volunteers (p<0.005) and HCV-ve controls (p=0.03). There was a significant association between elevated FWM mI/creatine and prolonged working memory reaction times (R=0.72, p=0.002). CONCLUSIONS: Elevated FWM mI/ creatine is a feature of HIV-related minor cognitive-motor disorder. It is associated with infection and immune activation of microglial cells. The similar findings in this study suggest that cerebral immune activation may also occur in HCV infection. This may underlie the mild neurocognitive impairment and neuropsychological symptoms observed in a proportion of patients.
BACKGROUND/AIMS: Abnormal cerebral metabolism and cognitive impairments have been reported in patients with chronic hepatitis C (HCV) but studies have failed to demonstrate a relationship between these findings. METHODS: Twenty-five HCV-positive patients with histologically-mild liver disease were studied with cerebral proton magnetic resonance spectroscopy (MRS), using acquisition parameters to quantify myo-inositol (mI) and other metabolites in frontal white matter (FWM). Patients underwent automated attention and working memory tests (Cognitive Drug Research test system). RESULTS: The mean mI/ creatine ratio in the HCV+ve patients (0.64, SD 0.21) was significantly higher (p=0.02) than in healthy controls (0.52, SD 0.10). On cognitive testing, the HCV+ve patients showed impairments in 2/4 composite scores, reflecting working memory and attention, compared to normative data from healthy volunteers (p<0.005) and HCV-ve controls (p=0.03). There was a significant association between elevated FWM mI/creatine and prolonged working memory reaction times (R=0.72, p=0.002). CONCLUSIONS: Elevated FWM mI/ creatine is a feature of HIV-related minor cognitive-motor disorder. It is associated with infection and immune activation of microglial cells. The similar findings in this study suggest that cerebral immune activation may also occur in HCV infection. This may underlie the mild neurocognitive impairment and neuropsychological symptoms observed in a proportion of patients.
Authors: Assawin Gongvatana; Ronald A Cohen; Stephen Correia; Kathryn N Devlin; Jadrian Miles; Hakmook Kang; Hernando Ombao; Bradford Navia; David H Laidlaw; Karen T Tashima Journal: J Neurovirol Date: 2011-10-01 Impact factor: 2.643
Authors: Angela Matinella; M Lanzafame; M A Bonometti; A Gajofatto; E Concia; S Vento; S Monaco; S Ferrari Journal: J Neurol Date: 2015-04-01 Impact factor: 4.849
Authors: David A Sheridan; S H Bridge; M M E Crossey; D J Felmlee; H C Thomas; R D G Neely; S D Taylor-Robinson; M F Bassendine Journal: Metab Brain Dis Date: 2014-03-12 Impact factor: 3.584
Authors: Howard Crystal; Inna Kleyman; Kathryn Anastos; Jason Lazar; Mardge Cohen; Chenglong Liu; Leigh Pearce; Elizabeth Golub; Victor Valcour; Ann Ho; Howard Strickler; Marion Peters; Andrea Kovacs; Susan Holman; Mary Jeanne Kreek; Jennifer Manly Journal: J Acquir Immune Defic Syndr Date: 2012-02-01 Impact factor: 3.731