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Effect of glymphatic system function on cognitive function in patients with chronic kidney disease
Junghae Ko1, Bong Soo Park1, Chang Min Heo1
1Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea.
Frontiers in Neurology
|October 7, 2024
Summary
Chronic kidney disease (CKD) is linked to impaired brain connectivity and glymphatic system dysfunction. Lower DTI-ALPS index in CKD patients with cognitive impairment suggests glymphatic dysfunction impacts cognition.
Area of Science:
- Neuroimaging
- Nephrology
- Cognitive Neuroscience
Background:
- Chronic kidney disease (CKD) is associated with neurological complications, including impaired structural brain connectivity and glymphatic system dysfunction.
- The glymphatic system, crucial for waste clearance in the brain, may be compromised in CKD patients.
Purpose of the Study:
- To investigate the relationship between structural brain connectivity, glymphatic system function, and cognitive function in patients with CKD.
- To compare neuroimaging markers between CKD patients and healthy controls, and between CKD patients with and without cognitive impairment.
Main Methods:
- Prospective enrollment of CKD patients and healthy controls.
- Brain magnetic resonance imaging (MRI) including diffusion tensor imaging (DTI).
- Calculation of structural connectivity measures and the diffusion tensor image analysis along the perivascular space (DTI-ALPS) index.
Main Results:
- CKD patients exhibited lower clustering coefficient, local efficiency, and small-worldness index compared to healthy controls.
- The DTI-ALPS index, a marker of glymphatic function, was significantly lower in CKD patients than in controls.
- CKD patients with cognitive impairment showed a lower DTI-ALPS index compared to those without cognitive impairment, while structural connectivity did not differ.
Conclusions:
- Reduced DTI-ALPS index in CKD patients suggests glymphatic system dysfunction.
- The DTI-ALPS index is a potential indicator of cognitive impairment in CKD, highlighting the link between glymphatic function and cognition.
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