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Changes in Cerebral Volume and White Matter Integrity in Adults on Hemodialysis and Relationship to Cognitive

Wesley T Richerson1, Laura G Umfleet2, Brian D Schmit3

  • 1Department of Biomedical Engineering, Marquette University and Medical College of Wisconsin, Milwaukee, Wisconsin, USA, wesley.richerson@marquette.edu.

Nephron
|October 13, 2020
PubMed

Insights

Patients undergoing hemodialysis (HD) show reduced gray matter and white matter integrity in the brain. This impaired brain structure is linked to poorer cognitive function, particularly executive function and memory.

Area of Science:

  • Neuroscience
  • Nephrology
  • Radiology

Background:

  • Cognitive impairment is a significant issue for patients on hemodialysis (HD).
  • Understanding the brain's structural changes and their link to cognitive function in HD patients is crucial for clarifying disease mechanisms.

Purpose of the Study:

  • To characterize cerebral structural differences in HD patients compared to healthy controls.
  • To evaluate the relationship between cerebral structural integrity and cognitive performance in HD patients.

Main Methods:

  • A cross-sectional study involving in-center HD patients (≥50 years) and age-matched controls.
  • Brain structural and diffusion MRIs were performed, alongside cognitive assessment using the NIH Toolbox.
  • Gray matter volume, white matter volume, and white matter integrity (fractional anisotropy) were measured.

Main Results:

  • HD patients exhibited decreased gray matter volume (526.8 vs. 589.5 cm3, p < 0.01) and reduced white matter integrity (FA values of 0.2864 vs. 0.3441, p < 0.01) compared to controls.
  • Reduced white matter integrity in the superior longitudinal fasciculus correlated with lower executive function scores (r2 = 0.24, p = 0.02).
  • Impaired integrity in the longitudinal fasciculus was associated with lower memory scores (r2 = 0.21–0.25, p = 0.03).

Conclusions:

  • Hemodialysis patients demonstrate a pattern of gray matter atrophy and decreased white matter integrity relative to healthy individuals.
  • These structural brain changes, particularly in white matter integrity, are associated with diminished cognitive performance in the HD population.
Abstract

Keywords:
CognitionGray matter volumeHemodialysisWhite matter integrity

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