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Postural imbalance: An early sign in HIV-1 infected patients

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Summary

We have recorded postural performance in 50 HIV-infected patients in different stages of the disease (Walter Reed (WR) stages I–VI) by means of a force measuring platform. The results were compared with 50 age-matched controls. A significant instability was particularly evident when standing on an unstable foot support. In patients standing with “eyes closed”, postural sway was significantly higher in every patient group (WR I–II:P<0.02, WR III–V:P<0.001, WR VI:P<0.001). Patients in stage WR I–II showed no relevant neurological abnormalities. In agreement with other neurophysiological data in the literature we suggest that postural imbalance could be an early sign of central nervous system penetration of HIV. No correlation with electromyographic or cerebrospinal fluid findings could be found.

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References

  1. Appleman ME, Marshall DW, Brey RL, Houk RW, Beatty DC, Winn RE, Melcher GP, Wise MG, Sumaya CV, Boswill RN (1988) Cerebrospinal fluid abnormalities in patients without AIDS who are seropositive for human immunodeficiency virus. J Infect Dis 158:193–199

    Google Scholar 

  2. Arendt G, Hefter H, Elsing C, Neuen-Jacob E, Strohmeyer G, Freund HJ (1989) Neue elektrophysiologische Befunde zur Häufigkeit der Gehirnbeteiligung bei klinisch-neurologisch asymptomatischen HIV-Infizierten. ZEEG-EMG 20:280–287

    Google Scholar 

  3. Dilley JW, Boccellari A, Yingling G, Moss A, Wagner B, Kelly T (1989) Sequelae of HIV infection: evoked potential latencies, neuropsychological performance, and immune dysfunction in HIV-seropositive and HIV-seronegative gay men. Presented at the Sixth International Conference on AIDS. San Francisco, June 20–24, abstract

  4. Gartner S, Markovitz P, Markovitz DM, Betts RF, Popovic M (1986) Virus isolation and identification of HTLV-III/LAV producing cells in brain tissue from a patient with AIDS. JAMA 256:2365–2371

    Google Scholar 

  5. Goodin DS, Aminoff MJ, Chernoff DN, Hollander H (1990) Long latency event-related potentials in patients infected with human immunodeficiency virus. Ann Neurol 27:414–419

    Google Scholar 

  6. Graus F, Ribalta GF, Abos J, Alom J, Cruz-Sanchez F, Mallolas JM, Miro M, Cardesa A, Tolosa E (1990) Subacute cerebellar syndrome as the first manifestation of AIDS dementia complex. Acta Neurol Scand 81:118–120

    Google Scholar 

  7. Hansen ML, Henkes H, Scholz G, Terstegge K, Kubicki St, Ott H, Röske W (1989) Visuomotorische Koordinationsleistungen von AIDS-Patiente, HIV-positiven asymptomatischen Probanden und Gesunden im Videotracking. Z EEG-EMG 20:267–273

    Google Scholar 

  8. Helweg-Larsen S, Jacobsen J, Boesen F (1988) Myelopathy in AIDS. A clinical, neuroradiologial and electrophysiological study of 23 Danish patients with AIDS. Acta Neurol Scand 77:64–73

    Google Scholar 

  9. Hollander H (1988) Cerebrospinal fluid normalities and abnormalities in individuals infected with human immunodeficiency virus. J Infect Dis; 158:855–858

    Google Scholar 

  10. Janssen RS, Saykin AJ, Kaplan JE, Spira JT, Pinsky PF, Sprehn GC, Hoffman JC, Mayer WB, Schonberger LB (1988) Neurological complications of human immunodeficiency virus infection in patients with lymphadenopathy syndrome. Ann Neurol 23:49–55

    Google Scholar 

  11. Janssen RS, Saykin AJ, Cannon L, Campbell J, Pinsky PF, Hessol NA, O'Malley PM, Lifson AR, Doll LS, Rutherford GW, Kaplan JE (1989) Neurological and neuropsychological manifestations of HIV-1-infection: association with AIDS-related complex but not with asymptomatic HIV-1 infection. Ann Neurol 26:592–600

    Google Scholar 

  12. Kaiser R, Dörries R, Lüer W, Poser S, Pohle HD, Felgenhauer K, terMeulen V (1989) Analysis of oligoclonal antibody bands against individual HIV structural proteins in CSF of patients infected with HIV. J Neurol 236:157–160

    Google Scholar 

  13. 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 223:1089–1093

    Google Scholar 

  14. Koralnik IJ, Beaumanoir A, Häusler R, Kohler A, Safran AB, Delacoux R et al (1990) A controlled study of early neurologic abnormalities in men with asymptomatic human immunodeficiency virus infection. N Engl J Med 323:864–870

    Google Scholar 

  15. Maleßa R, Heuser-Link M, Brockmeyer N, Schwendemann (1989) Evozierte Potentiale bei neurologisch asymptomatischen Personen in frühen Stadien der HIV-Infektion. Z EEG-EMG 20:745–752

    Google Scholar 

  16. McArthur JC, Cohen BA, Selnes OA, Kumar AJ, Cooper K, McArthur JH, Soucy G, Cornblath DR, Chmiel JS, Wang M-C, Starkey DL, Ginzburg H, Ostrow DG, Johnson RT, Phair JP, Polk BF (1989) Low prevalence of neurological and neuropsychological abnormalities in otherwise healthy HIV-1-infected individuals: results form the multicenter AIDS cohort study. Ann Neurol 26:601–611

    Google Scholar 

  17. Navia BA, Price RW (1986) The acquired immunodeficiency syndrome dementia complex as the presenting or sole manifestation of human immunodeficiency virus infection. Arch Neurol 44:65–69

    Google Scholar 

  18. Nuwer MR, Miller EN, Visscher BR, Sath P (1991) Early neurologic abnormalities in HIV infection. N Engl J Med 324: 492–493

    Google Scholar 

  19. Paulus W, Straube A, Krafczyk S, Brandt T (1989) Differential effects of retinal target displacement, changing size and changing disparity in the control of anterior/posterior and lateral body sway. Exp Brain Res 78:243–252

    Google Scholar 

  20. Perdices M, Cooper DA (1989) Simple and choice reaction time in patients with human immunodeficiency virus infection. Ann Neurol 25:460–467

    Google Scholar 

  21. Redfield RR, Wright DC, Tramont EC (1986) The Walter Reed staging classification for HTLV III/LAV infection. N Engl J Med 314:131–132

    Google Scholar 

  22. Resnick L, Berger JR, Shapshak P, Tourtellotte WW (1988) Early penetration of the blood-brain barrier by HIV. Neurology 38:9–14

    Google Scholar 

  23. Rolfs A, Schumacher HC (1990) Early findings in the cerebrospinal fluid of patients with HIV-1 infection of the central nervous system. N Engl J of Med 323:419–420

    Google Scholar 

  24. Schielke E, Tatsch K, Pfister W, Trenkwalder C, Leinsinger G, Kirsch CM, Matuschke A, Einhäupl KM (1990) Reduced cerebral blood flow in early stages of human immunodeficiency virus infection. Arch Neurol 47:1342–1345

    Google Scholar 

  25. Selnes OA, Miller E, McArthur J (1990) HIV-1 infection: no evidence of cognitive decline during the asymptomatic stages. Neurology 40:204–208

    Google Scholar 

  26. Smith T, Jacobsen J, Gaub J, Helweg-Larsen S, Trojaborg W (1988) Clinical and electrophysiological studies of human immunodeficiency virus-positive men without AIDS. Ann Neurol 23:295–297

    Google Scholar 

  27. Sönnerborg A, Nybom R, Britton S, Ehrnst A, Forsgren M, Larsson PX, Strammegard Ö, Andersson J (1989) Detection of cell-free human immunodeficiency virus in cerebrospinal fluid by using immune scanning electron microscopy. J Infect Dis 159:1037–1041

    Google Scholar 

  28. Straube A, Bötzel K, Hawken M, Paulus W, Brandt Th (1988) Postural control in the elderly: differential effects of visual, vestibular and somatosensory input. In: Amblard B, Berthoz A, Clarac F (eds) Posture and gait: development, adaptation and modulation. Elsevier, Amsterdam, pp 105–114

    Google Scholar 

  29. Trenkwalder C, Straube A, Einhäupl K, Paulus W, Schielke E (1990) Postural imbalance as an early and frequent sign of HIV infection. In: Brandt Th, Paulus W, Bles W, Dieterich M, Krafczyk S, Straube A (eds) Disorders of posture and gait 1990. Thieme, Stuttgart, pp 443–447

    Google Scholar 

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Authors and Affiliations

  1. Department of Neurology, University of Munich, Klinikum Großhadern, Marchioninistrasse 15, W-8000, Munich 70, Federal Republic of Germany

    Claudia Trenkwalder, Andreas Straube, Walter Paulus, Siegried Krafczyk, Eva Schielke & Karl Max Einhäupl

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  1. Claudia Trenkwalder
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  2. Andreas Straube
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  3. Walter Paulus
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  4. Siegried Krafczyk
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  5. Eva Schielke
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  6. Karl Max Einhäupl
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Trenkwalder, C., Straube, A., Paulus, W. et al. Postural imbalance: An early sign in HIV-1 infected patients. Eur Arch Psychiatry Clin Nuerosci 241, 267–272 (1992). https://doi.org/10.1007/BF02195975

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  • DOI: https://doi.org/10.1007/BF02195975

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