11C-PiB imaging of human immunodeficiency virus-associated neurocognitive disorder

Beau M. Ances, Tammie L. Benzinger, Jon J. Christensen, Jewell Thomas, Rohit Venkat, Mengesha Teshome, Patricia Aldea, Anne M. Fagan, David M. Holtzman, John C. Morris, David B. Clifford

Research output: Contribution to journalArticle

46 Scopus citations

Abstract

Objective: To evaluate whether the amyloid-binding agent carbon 11-labeled Pittsburgh Compound B ( 11C-PiB) could differentiate Alzheimer disease (AD) from human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND) in middle-aged HIV-positive participants. Design: 11C-PiB scanning, clinical assessment, and cerebrospinal fluid (CSF) analysis were performed. Both χ 2 and t tests assessed differences in clinical and demographic variables between HIV-positive participants and community-living individuals observed at the Knight Alzheimer's Disease Research Center (ADRC). Analysis of variance assessed for regional differences in amyloid-βprotein 1-42 (Aβ42) using 11C-PiB. Setting: An ADRC and HIV clinic. Participants: Sixteen HIV-positive participants (11 cognitively normal and 5 with HAND) and 19 ADRC participants (8 cognitively normal and 11 with symptomatic AD). Main Outcome Measures: Mean and regional 11C-PiB binding potentials. Results: Participants with symptomatic AD were older (P<.001), had lower CSF Aβ42 levels (P<.001), and had higher CSF tau levels (P<.001) than other groups. Regardless of degree of impairment, HIV-positive participants did not have increased 11C-PiB levels. Mean and regional binding potentials were elevated for symptomatic AD participants (P<.001). Conclusions: Middle-aged HIV-positive participants, even with HAND, do not exhibit increased 11C-PiB levels, whereas symptomatic AD individuals have increased fibrillar Aβ42 deposition in cortical and subcortical regions. Observed dissimilarities between HAND and AD may reflect differences in Aβ42 metabolism. 11C-PiB may provide a diagnostic biomarker for distinguishing symptomatic AD from HAND in middle-aged HIV-positive participants. Future cross-sectional and longitudinal studies are required to assess the utility of 11C-PiB in older individuals with HAND.

Original languageEnglish
Pages (from-to)72-77
Number of pages6
JournalArchives of neurology
Volume69
Issue number1
DOIs
StatePublished - Jan 1 2012

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