Showing papers by "Terry L. Jernigan published in 1998"
TL;DR: In the absence of cerebral opportunistic disease, HIV infection causes progressive atrophy within the gray and white matter in the brain andStructural brain changes can begin in the early stages of HIV infection and accelerate during advanced illness.
Abstract: Objective To compare rates and anatomical patterns of brain atrophy during 3 stages of human immunodeficiency virus (HIV) disease. Design Comparisons of multiple serial brain magnetic resonance images in men without HIV infection and HIV-infected men in Centers for Disease Control and Prevention (CDC, Atlanta, Ga) stages A, B, and C. Setting Longitudinal cohort study of the San Diego HIV Neurobehavioral Research Center, San Diego, Calif. Participants Eighty-six HIV-1–positive (HIV-positive) and 23 HIV-negative men who were similar in age and risk group. The number of HIV-positive men in each CDC stage was as follows: A, 33; B, 19; C, 34. All HIV-positive men were free of clinically detectable opportunistic neurologic illness. Main Outcome Measures Regional volumes of serial magnetic resonance images converted to standardized slope estimates of change in regional volumes of interest. Results Medically asymptomatic men (CDC stage A) and medically symptomatic men (CDC stage C) had more rapid loss of cortical tissues than did HIV-negative men as manifested by higher slopes (Tukey honestly significant difference test,P=.02 andP=.001, respectively) for cortical fluid volume. Accelerated ventricular volume enlargement occurred only in men with CDC stage C disease. Reduction in the volume of white matter was accelerated in participants with CDC stage C disease compared with participants with CDC stage A disease. Of the gray matter regions, only the caudate nucleus sustained accelerated volume loss during CDC stage C disease. Participants whose systemic disease progressed to a higher CDC stage had significantly accelerated ventricular volume increases and caudate atrophy. Rates of cortical and subcortical fluid volume increases and reductions in the volumes of white matter and the caudate nucleus were significantly related to the rate of decline in the CD4+lymphocyte count. Conclusions In the absence of cerebral opportunistic disease, HIV infection causes progressive atrophy within the gray and white matter in the brain. These changes were most severe in the most advanced stage of disease but were evident even in medically asymptomatic HIV-positive persons. Within the gray matter, the caudate nucleus exhibited progressive volume loss linked to disease stage and the rate of decline of the CD4+cell count. Structural brain changes can begin in the early stages of HIV infection and accelerate during advanced illness.
179 citations
TL;DR: In this article, the mesial temporal lobe and the anterior diencephalon of the human brain were measured using magnetic resonance imaging (MRI) images and found significant changes in asymmetry with increasing age, possibly due to the changing levels of gonadal steroid hormones known to occur during this age range.
Abstract: In this article, we extend earlier findings of age‐related changes in brain morphology on magnetic resonance images to include measurements of the mesial temporal lobe as well as asymmetry measures in regional cortical and subcortical structures. The earlier sample was increased to include 57 children and young adults aged 8 to 35 years. The participants were studied using quantitative image analytic techniques. Estimated volumes of limbic and anterior diencephalic structures increased significantly with age; although inferior lateral cortex, superior cortex, caudate nuclei, thalamus, and lenticular nuclei all decreased significantly with age. Of the 7 regions measured, only the lenticular nucleus and anterior diencephalon showed significant changes in asymmetry with increasing age. It is hypothesized that some of these changes may be related to the changing levels of gonadal steroid hormones known to occur during this age range. They may also have important implications for the study of late developing h...
83 citations
TL;DR: A model for predicting AOS consisting of abstraction and thalamic and caudate volumes remained significant after controlling for duration of illness, current age and daily neuroleptic dose.
Abstract: Age of onset of schizophrenia (AOS) may be largely determined by neurobiological factors. We examined in a diverse sample of schizophrenia out-patients the relationships of AOS with neuropsychological abilities and structural brain abnormalities as measured on cerebral magnetic resonance imaging (MRI). A total of 82 out-patients meeting DSM-III-R criteria for schizophrenia were evaluated with a comprehensive neuropsychological battery and semi-automated quantitatively analysed cerebral MRI. Earlier AOS correlated with poorer performance in learning and abstraction/ cognitive flexibility, and with larger volumes of caudate and lenticular nuclei, and smaller volume of thalamus on MRI. A model for predicting AOS consisting of abstraction and thalamic and caudate volumes remained significant after controlling for duration of illness, current age and daily neuroleptic dose. In conclusion, AOS may be related to specific rather than general measures of cognitive performance and structural brain abnormalities.
59 citations
TL;DR: Clear differences between word identification and word recognition were observed: the latter task evoked considerably more prefrontal activity and stronger cerebellar activation and Stimulus degradation was associated with focal increases in bilateral fusiform regions within the occipital lobe.
50 citations