Brain cell injury in HIV infection: when does it start and can it be stopped?

The study by Young and colleagues1 in this issue of Neurology® used a technique called magnetic resonance spectroscopy (MRS) to examine the brain chemistry of patients with HIV. MRS is a noninvasive method of measuring the levels of certain chemicals, or “metabolites,” in the brain. One metabolite, N -acetylaspartate (NAA), is a marker of healthy brain cells. Three other metabolites, choline (Cho), myo-inositol (MI), and glutamate (Glu), are markers of damaged brain cells and inflammation (see table).