Analysis of the effects of injecting drug use and HIV-1 infection on 18F-FDG PET brain metabolism

Michalis F. Georgiou, Ati Gonenc, Drenna Waldrop-Valverde, Russ Aaron Kuker, Shabbir Ezuddin, George N Sfakianakis, Mahendra Kumar

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Injecting drug use (IDU) is a major risk factor for contracting HIV-1 infection. Both HIV and IDU are neurotoxic, and their coexistence may lead to increased dysfunction of brain metabolic processes. The objective of this research was to investigate the effects of HIV-1 infection and IDU on 18F-FDG PET brain metabolism. Methods: 18F-FDG PET brain imaging, with a standard clinical protocol, was performed on 59 subjects who belonged to 3 groups: HIV-positive/IDU-positive (n = 17), HIV-negative/IDU- positive (n = 13), and HIV-negative/IDU-negative controls (n = 29). A voxel-based analysis of the 18F-FDG PET brain images was performed using statistical parametric mapping. The imageswere spatially normalized to a standard 18F-FDG template, proportionally scaled to compensate for count differences, and then appropriately smoothed. Statistical 2-sample t tests were performed to determine regional metabolic distribution differences in the 3 groups. Results: Diffuse hypermetabolism in the subcortical and deep white matter, the basal ganglia, and the thalami was observed in HIV-1 infection. IDU resulted in increased brainstem metabolism and decreased activity in cortical structures including bilateral medial frontal lobes and the right inferior frontal and temporal cortices. The cortical hypometabolism was more extensive in HIV-1-infected subjects, involving the left temporoparietal and right parietal cortices and bilateral medial frontal lobes. Conclusion: Voxel-based analysis of 18F-FDG PET brain images demonstrated statistically significant differences in regional metabolism for the 3 studied groups. It also showed that HIV-1 infection may have a synergistic effect with IDU, resulting in more extensive cortical hypometabolism. Correlation of these findings with other quantitative approaches and neurocognitive functioning is warranted.

Original languageEnglish (US)
Pages (from-to)1999-2005
Number of pages7
JournalJournal of Nuclear Medicine
Issue number12
StatePublished - Dec 1 2008


  • F-FDG PET brain imaging
  • HIV-1 infection
  • Injecting drug use
  • Statistical parametric mapping

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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