Lithium Therapy for Human Immunodeficiency Virus Type 1-associated Neurocognitive Impairment

Overview

Journal J Neurovirol

Publisher Springer

Specialties Microbiology
Neurology

Date 2009 Mar 24

PMID 19306230

Citations 34

Authors

Giovanni Schifitto

Jianhui Zhong

David Gill

Derick R Peterson

Michelle D Gaugh

Tong Zhu

Madalina Tivarus

Kim Cruttenden

Sanjay B Maggirwar

Howard E Gendelman

Stephen Dewhurst

Harris A Gelbard

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to assess lithium safety and tolerability and to explore its impact on cognition, function, and neuroimaging biomarkers in human immunodeficiency virus (HIV)-infected subjects with cognitive impairment. Fifteen cognitively impaired HIV-infected subjects were enrolled in this 10-week open-label study of lithium 300 mg twice daily. Neuroimaging was performed at baseline and following 10 weeks of treatment and included magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI), and functional MRI (fMRI). Thirteen of the 14 subjects (93%) that complied with the study visits were able to complete the study on lithium and 11 out of 13 (79%) completed the study at the originally assigned dose of 300 mg twice daily. There were no significant changes in CD4(+) lymphocyte cell count and plasma HIV RNA. Cognitive performance and depressive mood did not improve significantly after the 10-week lithium treatment; however, neuroimaging revealed a decrease in the glutamate+glutamine (Glx) peak in the frontal gray matter, increased fractional anisotropy, and decreased mean diffusivity in several brain areas, and changes in brain activation patterns, suggestive of improvement. These results suggest that lithium can be used safely in HIV-infected individuals with cognitive impairment. Furthermore, the neuroimaging results suggest that lithium may improve HIV-associated central nervous system (CNS) injury; thus, further investigations of lithium as an adjunctive treatment for HIV-associated cognitive impairment are warranted.

Citing Articles

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