Lithium therapy for human immunodeficiency virus type 1-associated neurocognitive impairment

Giovanni Schifitto, Jianhui Zhong, David Gill, Derick R. Peterson, Michelle Gaugh, Tong Zhu, Madalina Tivarus, Kim Cruttenden, Sanjay B. Maggirwar, Howard Eliot Gendelman, Stephen Dewhurst, Harris A. Gelbard

Research output: Contribution to journalArticle

47 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)176-186
Number of pages11
JournalJournal of neurovirology
Volume15
Issue number2
DOIs
StatePublished - Jul 22 2009

Fingerprint

Lithium
HIV-1
HIV
Neuroimaging
CD4 Lymphocyte Count
Therapeutics
Nervous System Trauma
Diffusion Tensor Imaging
Anisotropy
Brain
Glutamine
Cognition
Glutamic Acid
Magnetic Resonance Spectroscopy
Central Nervous System
Biomarkers
Magnetic Resonance Imaging
RNA
Safety
Cognitive Dysfunction

Keywords

  • Cognitive impairment
  • HIV
  • Lithium
  • Neuroimaging
  • fMRI

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Virology

Cite this

Schifitto, G., Zhong, J., Gill, D., Peterson, D. R., Gaugh, M., Zhu, T., ... Gelbard, H. A. (2009). Lithium therapy for human immunodeficiency virus type 1-associated neurocognitive impairment. Journal of neurovirology, 15(2), 176-186. https://doi.org/10.1080/13550280902758973

Lithium therapy for human immunodeficiency virus type 1-associated neurocognitive impairment. / Schifitto, Giovanni; Zhong, Jianhui; Gill, David; Peterson, Derick R.; Gaugh, Michelle; Zhu, Tong; Tivarus, Madalina; Cruttenden, Kim; Maggirwar, Sanjay B.; Gendelman, Howard Eliot; Dewhurst, Stephen; Gelbard, Harris A.

In: Journal of neurovirology, Vol. 15, No. 2, 22.07.2009, p. 176-186.

Research output: Contribution to journalArticle

Schifitto, G, Zhong, J, Gill, D, Peterson, DR, Gaugh, M, Zhu, T, Tivarus, M, Cruttenden, K, Maggirwar, SB, Gendelman, HE, Dewhurst, S & Gelbard, HA 2009, 'Lithium therapy for human immunodeficiency virus type 1-associated neurocognitive impairment', Journal of neurovirology, vol. 15, no. 2, pp. 176-186. https://doi.org/10.1080/13550280902758973
Schifitto, Giovanni ; Zhong, Jianhui ; Gill, David ; Peterson, Derick R. ; Gaugh, Michelle ; Zhu, Tong ; Tivarus, Madalina ; Cruttenden, Kim ; Maggirwar, Sanjay B. ; Gendelman, Howard Eliot ; Dewhurst, Stephen ; Gelbard, Harris A. / Lithium therapy for human immunodeficiency virus type 1-associated neurocognitive impairment. In: Journal of neurovirology. 2009 ; Vol. 15, No. 2. pp. 176-186.
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