Pyramidal tract is affected in tropical spastic paraparesis (HAM/TSP) and AIDS; the best paraclinic tool so far known to evaluate such involvement, in humans, is transcranial magnetic stimulation. A thorough investigation was done in MEDLINE database for the period between 1985 and 2009, and in Scielo.org between 1996 and 2009 using the terms “HTLV-I, HTLV-II, HTLV-III, HIV; HIV1, HIV2, evoked potential, motor evoked potential, transcranial magnetic stimulation, magnetic stimulation, corticomotor physiology, motor tracts, pyramidal tract, corticospinal tract, myelopathy, acquired immunodeficiency syndrome, AIDS, SIDA, tropical spastic paraparesis, HTLV-I associated myelopathy, HAM, TSP, HAM/TSP”. Papers in English, Spanish, Portuguese, French and Japanese were reviewed. Thirteen manuscripts reporting motor evoked potentials obtained by transcranial magnetic stimulation were identified. In HAM/TSP the pyramidal tract involvement is mainly at low thoracic levels, following a centripetal pattern; in HIV, such involvement follows a centrifugal pattern which is greater at brain level. These findings should allow to redirect neurohabilitation and neuromodulation measures hopefully before fatal outcome or disability take place in these retroviruses-associated neurodegenerative disorders.
SIDA
Estimulación Magnética Trascraneal en los Retrovirus Humanos: Una Revisión Sistematica Desde 1985 a 2009.
Palabras clave: estimulación magnética trascraneal,
estimulación trascraneal no invasiva,
HAM/TSP,
HTLV-I,
SIDA,
tracto piramidal,
VIH,
Demencia y Parkinsonismo como Síntomas Iniciales en un Paciente con SIDA.
Dementia and Parkinsonism as early symptoms of AIDS are infrequent. We report the case of a male patient 62 years old, with a history of diabetes – insulin dependent and illicit drug use, who began his symptomatology with dementia and parkinsonism two months before his death.