The AIDS dementia complex

II. Neuropathology

B. A. Navia, E. S. Cho, Carol Petito, R. W. Price

Research output: Contribution to journalArticle

988 Citations (Scopus)

Abstract

In order to define the histopathological substrate of the dementia that frequently complicates the acquired immune deficiency syndrome (AIDS), we analyzed the neuropathological findings in 70 autopsied adult AIDS patients, 46 of whom had suffered clinically overt dementia. Less than 10% of the brains were histologically normal. Abnormalities were found predominantly in the white matter and in subcortical structures, with relative sparing of the cortex. Their frequency and severity generally correlated well with the degree and duration of clinical dementia. Most commonly noted was diffuse pallor in the white matter, which in the pathologically milder cases was accompanied by scanty perivascular infiltrates of lymphocytes and brown-pigmented macrophages, and in the most advanced cases by clusters of foamy macrophages and multinucleated cells associated with multifocal rarefaction of the white matter. However, in nearly one third of the demented cases the histopathological findings were remarkably bland in relation to the severity of clinical dysfunction. In addition, similar mild changes were noted in over one half of the nondemented patients, consistent with subclinical involvement. Vacuoloar myelopathy was found in 23 patients and was generally more common and severe in patients with advanced brain pathology. Evidence of cytomegalovirus (CMV) infection was noted in nearly one quarter of the brains and was associated with a relative abundance of microglial nodules, but correlated neither with the major subcortical neuropathology nor with the clinical dementia, indicating that CMV infection likely represented a second, superimposed process. This study established the AIDS dementia complex as a distinct clinical and pathological entity and, together with accumulating virological evidence, suggests that it is caused by direct LAV/HTLV-III brain infection.

Original languageEnglish
Pages (from-to)525-535
Number of pages11
JournalAnnals of Neurology
Volume19
Issue number6
StatePublished - Jan 1 1986
Externally publishedYes

Fingerprint

AIDS Dementia Complex
Dementia
Cytomegalovirus Infections
Brain
Acquired Immunodeficiency Syndrome
Macrophages
Pallor
Spinal Cord Diseases
HIV Infections
Lymphocytes
Pathology
Neuropathology
White Matter

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Navia, B. A., Cho, E. S., Petito, C., & Price, R. W. (1986). The AIDS dementia complex: II. Neuropathology. Annals of Neurology, 19(6), 525-535.

The AIDS dementia complex : II. Neuropathology. / Navia, B. A.; Cho, E. S.; Petito, Carol; Price, R. W.

In: Annals of Neurology, Vol. 19, No. 6, 01.01.1986, p. 525-535.

Research output: Contribution to journalArticle

Navia, BA, Cho, ES, Petito, C & Price, RW 1986, 'The AIDS dementia complex: II. Neuropathology', Annals of Neurology, vol. 19, no. 6, pp. 525-535.
Navia BA, Cho ES, Petito C, Price RW. The AIDS dementia complex: II. Neuropathology. Annals of Neurology. 1986 Jan 1;19(6):525-535.
Navia, B. A. ; Cho, E. S. ; Petito, Carol ; Price, R. W. / The AIDS dementia complex : II. Neuropathology. In: Annals of Neurology. 1986 ; Vol. 19, No. 6. pp. 525-535.
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