Progressive peripheral and central sensory tract lesion in HIV-infected patients evidenced by evoked potentials (A three-year follow-up study)

Objective: to investigate progression of peripheral and central sensory trace lesion and its correlation to immunological deterioration. Methods: clinical and neurophysiological investigation (evoked potentials of the median and tibial nerve) and immunological parameters (CD4-cells, beta(2)-microglobuline) were followed up in 160 patients (24 females, 136 males, HIV infection for 2.7+/-2.3 years, mv+/-1 sd) up to four times over similar to 3 years regardless of disease stage and evidence of neurological symptoms. Recordings were done using needle electrodes over the Th12 and C7 spinous process and from the scalp (10/20 system) in the conventional manner. Statistical analysis was performed intraindividually and in comparison to normal laboratory values (n=96). Results: All parameters deteriorated during the follow-up period. Statistical analysis showed significant differences between probands and patients for evoked potentials, but also a significant deterioration for evoked potentials after three years at the end of the follow-up study. A significant correlation between progressive impairment of evoked potentials and laboratory data was found. Conclusion: HIV infection induces a progressive lesion of the ascending sensory tracts. The results indicate a peripheral neuropathy as well as a progressive lesion of the ascending central sensory tracts. Pathogenesis of polyneuropathy and of central sensory tract lesion is up to now conjectural. Laboratory investigations indicate a clear-cut correlation between immunological alterations induced by HIV infection and its neurologic manifestation on ascending sensory tracts. (C) 1998 Elsevier Science B.V. All rights reserved.