{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T22:33:49Z","timestamp":1781562829078,"version":"3.54.5"},"reference-count":44,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2004,10,8]],"date-time":"2004-10-08T00:00:00Z","timestamp":1097193600000},"content-version":"vor","delay-in-days":4055,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Annals of Neurology"],"published-print":{"date-parts":[[1993,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The cause of acquired immunodeficiency syndrome (AIDS) dementia, which is a frequent late manifestation of human immunodeficiency virus (HIV) infection, is unknown but radiological and pathological studies have implicated alterations in subcortical white matter. To investigate the pathological basis of these white matter abnormalities, we performed an immunocytochemical and histological analysis of subcortical white matter from AIDS patients with and without dementia, from pre\u2010AIDS patients (asymptomatic HIV\u2010seropositive patients), and from HIV\u2010seronegative control subjects. Reduced intensity of Luxol fast blue staining, designated \u201cdiffuse myelin pallor,\u201d was detected in 8 of 15 AIDS dementia patients, 3 of 13 AIDS nondemented patients, and none of the pre\u2010AIDS patients (n = 2) or control subjects (n = 9). In contrast to Luxol fast blue staining, sections stained immunocytochemically for myelin proteins did not show decreased staining intensities in regions of diffuse myelin pallor. In addition, neither demyelinated axons nor active demyelination were detected in light and electron micrographs of subcortical white matter from brains of patients with AIDS dementia. An increase in the number of perivascular macrophages and hypertrophy of astrocytes and microglia occurred in brain sections from HIV\u2010infected patients. These changes were not specific to dementia or regions of diffuse myelin pallor and they occurred in both gray and white matter. In contrast to the lack of myelin pathology in AIDS dementia brains, significant accumulations of serum proteins in white matter glia were detected in the brains of 12 of 12 patients with AIDS dementia and 6 of 12 AIDS patients without dementia. Serum protein\u2010immunopositive cortical neurons were detected in the frontal cortex of 11 of 12 patients with AIDS dementia and 3 of 12 nondemented AIDS patients. Seronegative control subjects showed minimal serum protein immunoreactivity in both cortex and white matter. We conclude therefore that alterations in the blood\u2010brain barrier and not demyelination contribute to the development of AIDS dementia.<\/jats:p>","DOI":"10.1002\/ana.410340307","type":"journal-article","created":{"date-parts":[[2005,1,1]],"date-time":"2005-01-01T00:25:42Z","timestamp":1104539142000},"page":"339-350","source":"Crossref","is-referenced-by-count":257,"title":["Cerebral white matter changes in acquired immunodeficiency syndrome dementia: Alterations of the blood\u2010brain barrier"],"prefix":"10.1002","volume":"34","author":[{"given":"Christopher","family":"Power","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pei\u2010Ann","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas O.","family":"Crawford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Wesselingh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan D.","family":"Glass","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin C.","family":"McArthur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce D.","family":"Trapp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,10,8]]},"reference":[{"key":"e_1_2_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410190602"},{"key":"e_1_2_1_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198711000-00001"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410190603"},{"key":"e_1_2_1_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00687573"},{"key":"e_1_2_1_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1750-3639.1991.tb00656.x"},{"key":"e_1_2_1_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199109000-00003"},{"key":"e_1_2_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(91)92786-2"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410290613"},{"key":"e_1_2_1_10_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.40.11.1757"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410310402"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410290215"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00690837"},{"key":"e_1_2_1_14_2","volume-title":"Fundamentals of neuropathology: morphologic basis of neurologic disorders","author":"Okazaki O","year":"1989"},{"key":"e_1_2_1_15_2","first-page":"223","volume-title":"Magnetic resonance imaging of the brain and spine","author":"Atlas SW","year":"1991"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.42.9.1707"},{"key":"e_1_2_1_17_2","first-page":"777","article-title":"CSF changes in a longitudinal study of 124 neurologically normal HIV\u20101\u2010infected United States Air Force personnel","volume":"4","author":"Marshall DW","year":"1991","journal-title":"J Acquir Immune Defic Syndr"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-199103000-00008"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.410320509"},{"key":"e_1_2_1_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00005072-199007000-00001"},{"key":"e_1_2_1_21_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00964417"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/0165-5728(84)90012-2"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00687397"},{"key":"e_1_2_1_24_2","first-page":"345","article-title":"Leakage and neuronal uptake of serum protein in aged and Alzheimer brains: a postmortem phenomenon with antemortem etiology","volume":"64","author":"Mori S","year":"1991","journal-title":"Lab Invest"},{"key":"e_1_2_1_25_2","first-page":"14","volume-title":"Principles of neurology","author":"Adams RD","year":"1985"},{"key":"e_1_2_1_26_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00310126"},{"key":"e_1_2_1_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00227814"},{"key":"e_1_2_1_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/0167-5699(90)90070-P"},{"key":"e_1_2_1_29_2","doi-asserted-by":"publisher","DOI":"10.1172\/JCI115140"},{"key":"e_1_2_1_30_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.171.2.439"},{"key":"e_1_2_1_31_2","doi-asserted-by":"publisher","DOI":"10.1084\/jem.172.2.497"},{"key":"e_1_2_1_32_2","first-page":"15","volume-title":"Head injury: basic and clinical aspects","author":"Povlistock JT","year":"1980"},{"key":"e_1_2_1_33_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.180.4089.971"},{"key":"e_1_2_1_34_2","unstructured":"WesselinghSL PowerC GlassJD et al . 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