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Motor dysfunction in HIV-infected patients without clinically detectable central-nervous deficit

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Summary

Motor tests were performed in 50 HIV-infected patients in all stages according to the current CDC classification, but without any clinically evident central nervous system deficit, and the results compared with an age-matched control group. Patients were excluded from the study if there was alcohol or drug abuse, fever and/or opportunistic cerebral infection. The parameters tested were postural tremor of the outstretched hands, most rapid voluntary alternating index finger movements (MRAM) and rise time of most rapid index finger extensions (MRC). Whereas tremor peak frequencies did not differ significantly in the patients and controls, MRAM and rise times of MRCs showed significant slowing in the patient group. Morphologically, the motor test performance of the HIV-infected patients was similar to that of patients with manifest basal ganglia disease (Parkinson's, Huntington's and Wilson's diseases). MRI scans of all patients were normal. It is concluded that in HIV-infected patients there is a very early subclinical central nervous system affection, especially of the basal ganglia, which is detectable with appropriate, quantitative motor function tests. These functional abnormalities precede the structural alterations in the MRI scans.

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References

  1. Allum JHJ, Dietz V, Freund H-J (1978) Neuronal mechanisms underlying physiological tremor. J Neurophysiol 41:557

    Google Scholar 

  2. Barnes DM (1986) AIDS-related brain damage unexplained. Science 232:1091–1093

    Google Scholar 

  3. Barnes DM (1987) Brain damage under active study. Science 235:1574–1577

    Google Scholar 

  4. Beresford TP, Blow FC, Hall RC (1986) AIDS encephalitis mimicking alcohol dementia and depression. Biol Psychiatry 21:394–397

    Google Scholar 

  5. Berger JR, Moskowitz L, Fischl M, Kelley E (1987) The neurological complications of AIDS: frequently the initial manifestation. Neurology 34 [Suppl 1]:134–135

    Google Scholar 

  6. Bruhn P (1987) AIDS and dementia: a quantitative neuropsychological study of unselected Danish patients. Acta Neurol Scand 76:443–447

    Google Scholar 

  7. Budka H (1986) Multinucleated giant cells in brain: a hallmark of the acquired immune deficiency syndrome (AIDS). Acta Neuropathol (Berl) 69:253–258

    Google Scholar 

  8. Dickson DW (1986) Multinucleated giant cells in acquired immunodeficiency syndrome encephalopathy. Arch Pathol Lab Med 110:967–968

    Google Scholar 

  9. Elder GA, Sever JL (1988) Neurologic disorders associated with AIDS retroviral infection. Rev Infect Dis 10:286–302

    Google Scholar 

  10. Epstein LG, Sharer LR, Gajdussek DC (1986) Hypothesis: AIDS encephalopathy is due to primary and persistent infection of the brain with a human retrovirus of the lentivirus subfamily. Med Hypotheses 21:87–96

    Google Scholar 

  11. Evarts EV, Teräväinen H, Calne DB (1981) Reaction time in Parkinson's disease. Brain 104:167–186

    Google Scholar 

  12. Freund H-J, Büdingen H-J (1978) The relationship between speed and amplitude of the fastest voluntary contractions of human arm muscles. Exp Brain Res 31:1–12

    Google Scholar 

  13. Freund H-J, Hummelsheim H (1985) Lesions of premotor cortex in man. Brain 108:697–733

    Google Scholar 

  14. Funke I, Hahn A, Rieber EP, Weiss E, Riethmüller G (1987) The cellular receptor CD4 of the human immunodeficiency virus is expressed on neurons and glial cells in human brain. J Exp Med 165:1230–1235

    Google Scholar 

  15. Gabuzda DH, Ho DD, Monte SM de la, Hirsch MS, Rota TR, Sobel RA (1986) Immunohisto-chemical identification of HTLV III antigen in brains of patients with AIDS. Ann Neurol 20:289–295

    Google Scholar 

  16. Gallo RC, Salahuddin SZ, Popovic M, Shearer GM, Kaplan MH, Haynes BF, Palker TJ, Redfield R, Oleske J, Safai B, White G, Foster P, Markham PD (1987) Frequent detection and isolation of cytopathic retroviruses (HTLV III) from patients with AIDS and at risk from AIDS. Science 224:500–503

    Google Scholar 

  17. Gartner S, Markovits P, Markovitz DM, Kaplan MH, Gallo RC, Popovic M (1986) The role of mononuclear phagocytes in HTLV III infection. Science 233:215–219

    Google Scholar 

  18. Hefter H, Hömberg V, Lange HW, Freund H-J (1987) Impairment of rapid movement in Huntington's disease. Brain 110:585–612

    Google Scholar 

  19. Hömberg V, Hefter H, Granseyer G, Strauss W, Lange H, Hennerici M (1986) Event-related potentials in patients with Huntington's disease and relatives at risk in relation to detailed psychometry. Electroencephalogr Clin Neurophys 63:552–569

    Google Scholar 

  20. Johnson RT, McArthur JC (1986) AIDS and the brain. Trends Neurosci 9:91–104

    Google Scholar 

  21. Kato T, Hirano A, Llena JF, Dembitzer HM (1987) Neuropathology of acquired immune deficiency syndrome (AIDS) in 53 autopsy cases with particular emphasis on microglial nodules and multinucleated giant cells. Acta Neuropathol (Berl) 73:287–294

    Google Scholar 

  22. Koenig S, Gendelman HE, Orenstein JM, Dal-Canto MC, Pezeshkpour GH, Yungbluth M, Janotta F, Aksamit A, Martin MA, Fauci AS (1986) Detection of AIDS virus in macrophages in brain tissue from AIDS patients with encephalopathy. Science 233:1089–1093

    Google Scholar 

  23. Maddan PJ, Dalgleish AG, McDougal JS, Clapham PR, Weiss RA, Axel R (1986) The T4 gene encodes the AIDS virus receptor and is expressed in the immune system and the brain. Cell 47:333–348

    Google Scholar 

  24. McArthur JC (1986) Neurological manifestations of acquired immunodeficiency syndrome. J Neurosci Nurs 18:242–249

    Google Scholar 

  25. Montagnier L (1985) Lymphadenopathy associated virus: from molecular biology to pathogenicity. Ann Intern Med 103:689–693

    Google Scholar 

  26. Moskowitz LB, Hensley GT, Chan JC, Gregorios J, Conley FK (1984) The neuropathology of acquired immune deficiency syndrome. Arch Pathol Lab Med 108:867–872

    Google Scholar 

  27. Nath A, Jankovic J, Pettigrew LC (1987) Movement disorders and AIDS. Neurology 37:37–41

    Google Scholar 

  28. Navia BA, Jordan BD, Price RW (1986) The AIDS dementia complex. I. Clinical features. Ann Neurol 19:517–524

    Google Scholar 

  29. Navia BA, Cho ES, Petito CK, Price RW (1986) The AIDS dementia complex. II. Neuropathology. Ann Neurol 19:525–535

    Google Scholar 

  30. Post MJD, Sheldon JJ, Hensley GT, Soila K, Tobias JA, Chan JC, Quencer RM, Moskowitz LB (1986) Central nervous system disease in acquired immunodeficiency syndrome: prospective correlation using CT, MR imaging and pathologic studies. Radiology 158:141–148

    Google Scholar 

  31. Price RW, Navia BA, Cho SS (1986) AIDS encephalopathy. In: Boos J, Thornton GF (eds) Infectious diseases of the central nervous system. Neurol Clin 4:285–301

    Google Scholar 

  32. Pumarola-Sune T, Navia BA, Cordon-Cardo C, Cho ES, Price RW (1987) HIV antigen in the brains of patients with the AIDS dementia complex. Ann Neurol 21:490–496

    Google Scholar 

  33. Schmitt FA, Bigley JW, McKinnis R, Logue PE, Evans RW, Drucker JL and the AZT Collaborative Working Group (1988) Neuropsychological outcome of Zidovudine (AZT). Treatment of patients with AIDS and AIDS related complex. N Engl J Med 319:24

    Google Scholar 

  34. Sharer LR, Cho ES, Epstein LG (1985) Multinucleated giant cells and HTLV III in AIDS encephalopathy. Hum Pathol 16:760

    Google Scholar 

  35. Stiles RN, Randall JE (1967) Mechanical factors in human tremor frequency. J Appl Physiol 23:324–330

    Google Scholar 

  36. Wiley CA, Schrier RD, Nelson JA, Lampert PW, Oldstone MBA (1986) Cellular localization of human immunodeficiency virus infection within the brains of acquired immune deficiency syndrome patients. Proc Natl Acad Sci USA 83:7089–7093

    Google Scholar 

  37. Yarchoan R, Brouwers P, Spitzer AR, Grafman J, Safai B, Perno CF, Larson SM, Berg G, Fischl MA, Wichman A, Thomas RV, Brunetta A, Schmidt PJ, Mylers CA, Broder S (1987) Response of human immunodeficiency virus associated neurological diseases to 3′azido-3′desoxythymidine. Lancet 1:132–135

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Federal Republic of Germany

    G. Arendt, H. Hefter & H.-J. Freund

  2. Department of Medicine, University of Düsseldorf, Moorenstrasse 5, D-4000, Düsseldorf, Federal Republic of Germany

    C. Elsing & G. Strohmeyer

Authors
  1. G. Arendt
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  2. H. Hefter
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  3. C. Elsing
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  4. G. Strohmeyer
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  5. H.-J. Freund
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Arendt, G., Hefter, H., Elsing, C. et al. Motor dysfunction in HIV-infected patients without clinically detectable central-nervous deficit. J Neurol 237, 362–368 (1990). https://doi.org/10.1007/BF00315660

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  • DOI: https://doi.org/10.1007/BF00315660

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