No previous study has reported reduced basal ganglia Glu in HIV+ children; together with reduced NAA this suggests neuronal cell loss. Neurons in the basal ganglia may be more vulnerable than other regions to damage via excitotoxicity because of their greater density of NDMA receptors (Lipton et al., 1991) or because of increased blood–brain barrier damage in these structures associated with high plasma viral load (Avison et al., 2004).