Additive Effects of HIV and Chronic Methamphetamine Use on Brain Metabolite Abnormalities

Am J Psychiatry. 2005 Feb;162(2):361-9. doi: 10.1176/appi.ajp.162.2.361.

Abstract

Objective: Proton magnetic resonance spectroscopy (1H-MRS) showed decreased neuronal marker N-acetylaspartate and increased glial marker myo-inositol in subjects with chronic methamphetamine use and in subjects infected with HIV. The authors sought to determine whether HIV and a history of chronic methamphetamine use might have additive or interactive effects on brain metabolite abnormalities.

Method: 1H-MRS was performed in 68 HIV-positive subjects (24 with a history of chronic methamphetamine use with a lifetime exposure of a mean of 2,167 g [SD=2,788] and last use a mean of 4.9 months earlier [SD=6.0]; 44 with no history of drug abuse) and 75 HIV-negative subjects (36 with a history of chronic methamphetamine use with a lifetime exposure of a mean of 8,241 g [SD=16,850] and last use a mean of 6.3 months earlier [SD=7.8]; 39 with no history of drug abuse). Concentrations of N-acetylaspartate, creatine, choline, and myo-inositol were measured in the frontal cortex, frontal white matter, and basal ganglia.

Results: HIV-negative subjects with a history of chronic methamphetamine use showed lower concentrations of the neuronal marker N-acetylaspartate in the frontal white matter and basal ganglia and higher concentrations of choline compounds and the glial marker myo-inositol in the frontal cortex, relative to subjects with no history of drug abuse. HIV-positive status was associated with lower concentrations of N-acetylaspartate and creatine in the frontal cortex and higher concentrations of myo-inositol in the white matter, compared with HIV-negative status. Compared to the mean concentrations of metabolites in HIV-negative subjects with no history of drug abuse, the mean concentrations in subjects with HIV and chronic methamphetamine use showed additive effects on N-acetylaspartate in all three regions (-9% in the basal ganglia, -7% in the frontal white matter, and -6% in the frontal gray matter), on creatine in the basal ganglia (-7%), and on myo-inositol in the frontal white matter (+11%).

Conclusions: The combined effects of HIV and chronic methamphetamine use were consistent with an additive model, suggesting additional neuronal injury and glial activation due to the comorbid conditions.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Amphetamine-Related Disorders / epidemiology
  • Amphetamine-Related Disorders / metabolism*
  • Aspartic Acid / analogs & derivatives*
  • Aspartic Acid / analysis
  • Basal Ganglia / chemistry
  • Brain / metabolism*
  • Brain Diseases / diagnosis*
  • Brain Diseases / metabolism
  • Choline / analysis
  • Chronic Disease
  • Comorbidity
  • Creatine / analysis
  • Female
  • Frontal Lobe / chemistry
  • HIV Seronegativity
  • HIV Seropositivity / diagnosis
  • HIV Seropositivity / epidemiology
  • HIV Seropositivity / metabolism*
  • Humans
  • Inositol / analysis
  • Magnetic Resonance Spectroscopy / statistics & numerical data*
  • Male
  • Methamphetamine / adverse effects*

Substances

  • Aspartic Acid
  • Methamphetamine
  • Inositol
  • N-acetylaspartate
  • Creatine
  • Choline