Cerebral white matter changes in acquired immunodeficiency syndrome dementia

Alterations of the blood-brain barrier

Christopher Power, Pei Ann Kong, Thomas Owen Crawford, Steven Wesselingh, Jonathan D. Glass, Justin Charles McArthur, Bruce D. Trapp

Research output: Contribution to journalArticle

Abstract

The cause of acquired immunodeficiency syndrome (AIDS) dementia, which is a frequent late manifestation of human immunodeficiency virus (HIV) infection, is unknown but radiological and pathological studies have implicated alterations in subcortical white matter. To investigate the pathological basis of these white matter abnormalities, we performed an immunocytochemical and histological analysis of subcortical white matter from AIDS patients with and without dementia, from pre-AIDS patients (asymptomatic HIV-seropositive patients), and from HIV-seronegative control subjects. Reduced intensity of Luxol fast blue staining, designated "diffuse myelin pallor," was detected in 8 of 15 AIDS dementia patients, 3 of 13 AIDS nondemented patients, and none of the pre-AIDS patients (n = 2) or control subjects (n = 9). In contrast to Luxol fast blue staining, sections stained immunocytochemically for myelin proteins did not show decreased staining intensities in regions of diffuse myelin pallor. In addition, neither demyelinated axons nor active demyelination were detected in light and electron micrographs of subcortical white matter from brains of patients with AIDS dementia. An increase in the number of perivascular macrophages and hypertrophy of astrocytes and microglia occurred in brain sections from HIV-infected patients. These changes were not specific to dementia or regions of diffuse myelin pallor and they occurred in both gray and white matter. In contrast to the lack of myelin pathology in AIDS dementia brains, significant accumulations of serum proteins in white matter glia were detected in the brains of 12 of 12 patients with AIDS dementia and 6 of 12 AIDS patients without dementia. Serum protein-immunopositive cortical neurons were detected in the frontal cortex of 11 of 12 patients with AIDS dementia and 3 of 12 nondemented AIDS patients. Seronegative control subjects showed minimal serum protein immunoreactivity in both cortex and white matter. We conclude therefore that alterations in the blood-brain barrier and not demyelination contribute to the development of AIDS dementia.

Original languageEnglish (US)
Pages (from-to)339-350
Number of pages12
JournalAnnals of Neurology
Volume34
Issue number3
StatePublished - Sep 1993

Fingerprint

Blood-Brain Barrier
Dementia
Acquired Immunodeficiency Syndrome
Myelin Sheath
Pallor
HIV
Blood Proteins
Brain
Demyelinating Diseases
Staining and Labeling
White Matter
Myelin Proteins
Microglia
Frontal Lobe
Virus Diseases
Neuroglia
Astrocytes
Hypertrophy
Axons
Macrophages

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Cerebral white matter changes in acquired immunodeficiency syndrome dementia : Alterations of the blood-brain barrier. / Power, Christopher; Kong, Pei Ann; Crawford, Thomas Owen; Wesselingh, Steven; Glass, Jonathan D.; McArthur, Justin Charles; Trapp, Bruce D.

In: Annals of Neurology, Vol. 34, No. 3, 09.1993, p. 339-350.

Research output: Contribution to journalArticle

Power, Christopher ; Kong, Pei Ann ; Crawford, Thomas Owen ; Wesselingh, Steven ; Glass, Jonathan D. ; McArthur, Justin Charles ; Trapp, Bruce D. / Cerebral white matter changes in acquired immunodeficiency syndrome dementia : Alterations of the blood-brain barrier. In: Annals of Neurology. 1993 ; Vol. 34, No. 3. pp. 339-350.
@article{b019a1b53c15465cb9ee8d6509e9cdf5,
title = "Cerebral white matter changes in acquired immunodeficiency syndrome dementia: Alterations of the blood-brain barrier",
abstract = "The cause of acquired immunodeficiency syndrome (AIDS) dementia, which is a frequent late manifestation of human immunodeficiency virus (HIV) infection, is unknown but radiological and pathological studies have implicated alterations in subcortical white matter. To investigate the pathological basis of these white matter abnormalities, we performed an immunocytochemical and histological analysis of subcortical white matter from AIDS patients with and without dementia, from pre-AIDS patients (asymptomatic HIV-seropositive patients), and from HIV-seronegative control subjects. Reduced intensity of Luxol fast blue staining, designated {"}diffuse myelin pallor,{"} was detected in 8 of 15 AIDS dementia patients, 3 of 13 AIDS nondemented patients, and none of the pre-AIDS patients (n = 2) or control subjects (n = 9). In contrast to Luxol fast blue staining, sections stained immunocytochemically for myelin proteins did not show decreased staining intensities in regions of diffuse myelin pallor. In addition, neither demyelinated axons nor active demyelination were detected in light and electron micrographs of subcortical white matter from brains of patients with AIDS dementia. An increase in the number of perivascular macrophages and hypertrophy of astrocytes and microglia occurred in brain sections from HIV-infected patients. These changes were not specific to dementia or regions of diffuse myelin pallor and they occurred in both gray and white matter. In contrast to the lack of myelin pathology in AIDS dementia brains, significant accumulations of serum proteins in white matter glia were detected in the brains of 12 of 12 patients with AIDS dementia and 6 of 12 AIDS patients without dementia. Serum protein-immunopositive cortical neurons were detected in the frontal cortex of 11 of 12 patients with AIDS dementia and 3 of 12 nondemented AIDS patients. Seronegative control subjects showed minimal serum protein immunoreactivity in both cortex and white matter. We conclude therefore that alterations in the blood-brain barrier and not demyelination contribute to the development of AIDS dementia.",
author = "Christopher Power and Kong, {Pei Ann} and Crawford, {Thomas Owen} and Steven Wesselingh and Glass, {Jonathan D.} and McArthur, {Justin Charles} and Trapp, {Bruce D.}",
year = "1993",
month = "9",
language = "English (US)",
volume = "34",
pages = "339--350",
journal = "Annals of Neurology",
issn = "0364-5134",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - Cerebral white matter changes in acquired immunodeficiency syndrome dementia

T2 - Alterations of the blood-brain barrier

AU - Power, Christopher

AU - Kong, Pei Ann

AU - Crawford, Thomas Owen

AU - Wesselingh, Steven

AU - Glass, Jonathan D.

AU - McArthur, Justin Charles

AU - Trapp, Bruce D.

PY - 1993/9

Y1 - 1993/9

N2 - The cause of acquired immunodeficiency syndrome (AIDS) dementia, which is a frequent late manifestation of human immunodeficiency virus (HIV) infection, is unknown but radiological and pathological studies have implicated alterations in subcortical white matter. To investigate the pathological basis of these white matter abnormalities, we performed an immunocytochemical and histological analysis of subcortical white matter from AIDS patients with and without dementia, from pre-AIDS patients (asymptomatic HIV-seropositive patients), and from HIV-seronegative control subjects. Reduced intensity of Luxol fast blue staining, designated "diffuse myelin pallor," was detected in 8 of 15 AIDS dementia patients, 3 of 13 AIDS nondemented patients, and none of the pre-AIDS patients (n = 2) or control subjects (n = 9). In contrast to Luxol fast blue staining, sections stained immunocytochemically for myelin proteins did not show decreased staining intensities in regions of diffuse myelin pallor. In addition, neither demyelinated axons nor active demyelination were detected in light and electron micrographs of subcortical white matter from brains of patients with AIDS dementia. An increase in the number of perivascular macrophages and hypertrophy of astrocytes and microglia occurred in brain sections from HIV-infected patients. These changes were not specific to dementia or regions of diffuse myelin pallor and they occurred in both gray and white matter. In contrast to the lack of myelin pathology in AIDS dementia brains, significant accumulations of serum proteins in white matter glia were detected in the brains of 12 of 12 patients with AIDS dementia and 6 of 12 AIDS patients without dementia. Serum protein-immunopositive cortical neurons were detected in the frontal cortex of 11 of 12 patients with AIDS dementia and 3 of 12 nondemented AIDS patients. Seronegative control subjects showed minimal serum protein immunoreactivity in both cortex and white matter. We conclude therefore that alterations in the blood-brain barrier and not demyelination contribute to the development of AIDS dementia.

AB - The cause of acquired immunodeficiency syndrome (AIDS) dementia, which is a frequent late manifestation of human immunodeficiency virus (HIV) infection, is unknown but radiological and pathological studies have implicated alterations in subcortical white matter. To investigate the pathological basis of these white matter abnormalities, we performed an immunocytochemical and histological analysis of subcortical white matter from AIDS patients with and without dementia, from pre-AIDS patients (asymptomatic HIV-seropositive patients), and from HIV-seronegative control subjects. Reduced intensity of Luxol fast blue staining, designated "diffuse myelin pallor," was detected in 8 of 15 AIDS dementia patients, 3 of 13 AIDS nondemented patients, and none of the pre-AIDS patients (n = 2) or control subjects (n = 9). In contrast to Luxol fast blue staining, sections stained immunocytochemically for myelin proteins did not show decreased staining intensities in regions of diffuse myelin pallor. In addition, neither demyelinated axons nor active demyelination were detected in light and electron micrographs of subcortical white matter from brains of patients with AIDS dementia. An increase in the number of perivascular macrophages and hypertrophy of astrocytes and microglia occurred in brain sections from HIV-infected patients. These changes were not specific to dementia or regions of diffuse myelin pallor and they occurred in both gray and white matter. In contrast to the lack of myelin pathology in AIDS dementia brains, significant accumulations of serum proteins in white matter glia were detected in the brains of 12 of 12 patients with AIDS dementia and 6 of 12 AIDS patients without dementia. Serum protein-immunopositive cortical neurons were detected in the frontal cortex of 11 of 12 patients with AIDS dementia and 3 of 12 nondemented AIDS patients. Seronegative control subjects showed minimal serum protein immunoreactivity in both cortex and white matter. We conclude therefore that alterations in the blood-brain barrier and not demyelination contribute to the development of AIDS dementia.

UR - http://www.scopus.com/inward/record.url?scp=0027257418&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027257418&partnerID=8YFLogxK

M3 - Article

VL - 34

SP - 339

EP - 350

JO - Annals of Neurology

JF - Annals of Neurology

SN - 0364-5134

IS - 3

ER -