Diffusion tensor MRI evaluation of the corona radiata, cingulate gyri, and corpus callosum in HIV patients.

Objective: To evaluate the white matter integrity of the corona radiata, cingulate gyri, and corpus callosum in patients with human immunodeficiency virus (HIV) infection through diffusion tensor imaging (DTI).

Methods: Thirty-four patients with at least 5 years of HIV infection and 27 healthy controls underwent magnetic resonance imaging (MRI) in a 1.5 T scanner. A voxelwise-based technique was used to analyze the DTI data.

Results: We found that in the body of corpus callosum the fractional anisotropy (FA) was significantly reduced, whereas mean diffusivity (MD) and radial diffusivity (RD) were increased in HIV patients. Analyzing the corona radiata, axial diffusivity (AD) and MD were significantly increased in the left superior region, MD and RD were increased in the left posterior area, and, furthermore, MD was also increased in the right posterior region. No significant abnormalities were found on the cingulate gyri. The white matter damage, related to FA reduction, was associated with increased RD, indicating that demyelization might be the pathophysiological result of this damage.

Conclusions: Since the DTI can detect abnormalities in the normal-appearing white matter, this technique may play a role as an early marker of HIV disease progression, including clinical manifestations such as cognitive impairment.