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Published on: June 23, 2015
Early pediatric chronic kidney disease is associated with brain volumetric gray matter abnormalities
Matthew A Solomon1, Ellen van der Plas2, Kathleen E Langbehn2
1University of Iowa Stead Family Department of Pediatrics, Iowa City, IA, USA.
Insights
Pediatric chronic kidney disease (pCKD) alters brain structure, with smaller cerebellar gray matter linked to lower verbal fluency and larger cerebral gray matter associated with poorer math skills in children.
Area of Science:
- Neuroscience
- Nephrology
- Pediatrics
Background:
- The impact of pediatric chronic kidney disease (pCKD) on brain development is not well understood.
- Existing research lacks data connecting brain morphometry with cognitive deficits in children with pCKD.
Purpose of the Study:
- To compare brain morphometry in children with early-stage pCKD and typically developing peers.
- To investigate the relationship between brain structure, cognitive function, and CKD markers in pediatric patients.
Main Methods:
- Structural magnetic resonance imaging (MRI) was used to assess brain morphometry in 18 children with pCKD (stages 1-3) and 24 controls (ages 6-16).
- Volumetric data were analyzed using linear models, controlling for age, maternal education, and socioeconomic status.
- Neurocognitive testing was performed to assess verbal fluency and mathematics skills.
Main Results:
- Children with pCKD showed significantly smaller cerebellar gray matter volume (p=0.01) and larger cerebral gray matter volume (p=0.04) compared to controls.
- Reduced cerebellar gray matter volume correlated with lower estimated glomerular filtration rate (eGFR) (p=0.04), indicating a link to disease severity.
- Smaller cerebellar gray matter predicted lower verbal fluency, and larger cerebral gray matter predicted lower mathematics performance in the pCKD group.
Conclusions:
- This study provides preliminary evidence of distinct brain morphometric changes in children with early-stage pCKD.
- These findings suggest a potential morphometric basis for the cognitive deficits observed in pediatric chronic kidney disease.
- Brain structural alterations in pCKD may be linked to disease severity and impact specific cognitive functions.
Background:
The impact of pediatric chronic kidney disease (pCKD) on the brain remains poorly defined. The objective of this study was to compare brain morphometry between children with early-stage pCKD and typically developing peers using structural magnetic resonance imaging (MRI).
Methods:
The sample age range was 6-16 years. A total of 18 children with a diagnosis of pCKD (CKD stages 1-3) due to congenital anomalies of the kidney and urinary tract and 24 typically developing peers were included. Volumetric data from MRI and neurocognitive testing were compared using linear models including pCKD status, age, maternal education level, and socioeconomic status.
Results:
Cerebellar gray matter volume was significantly smaller in pCKD, t(38) = -2.71, p = 0.01. In contrast, cerebral gray matter volume was increased in pCKD, t(38) = 2.08, p = 0.04. Reduced cerebellum gray matter volume was associated with disease severity, operationalized as estimated glomerular filtration rate (eGFR), t(14) = 2.21, p = 0.04 and predicted lower verbal fluency scores in the pCKD sample. Enlarged cerebral gray matter in the pCKD sample predicted lower scores on mathematics assessment.
Conclusions:
This study provides preliminary evidence for a morphometric underpinning to the cognitive deficits observed in pCKD.
Impact:
The impact of pediatric chronic kidney disease (CKD) on the brain remains poorly defined, with no data linking brain morphometry and observed cognitive deficits noted in this population. We explored the relationship between brain morphometry (using structural magnetic resonance imaging), cognition, and markers of CKD. Cerebellar and cerebral gray matter volumes are different in early CKD. Volumetric decreases in cerebellar gray matter are predicted by lower eGFR, suggesting a link between disease and brain morphometry. Reduced cerebellar gray matter predicted lower verbal fluency for those with pCKD. Enlarged cerebral gray matter in the pCKD sample predicted lower mathematics performance.
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