Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging

Li, Xiufeng; Slinin, Yelena; Zhang, Lin; Dengel, Donald R.; Tupper, David E.; Metzger, Gregory J.; Murray, Anne M.

doi:10.1016/j.nicl.2020.102434

Cited by 13 publications

(15 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The hippocampus plays an important role in cognitive memory and reasoning decisions [ 17 , 18 ]. Our results are consistent with those of previous studies [ 19 , 20 ]. For instance, Cheng BC et al used ASL to study CBF changes in ESRD patients on long-term peritoneal dialysis therapy and compared CBF in ESRD patients before and after peritoneal dialysis with that of HCs; they found that ESRD patients had a mean increase in CBF compared to HCs and that higher CBF in the left hippocampus of ESRD patients was associated with worse executive function [ 19 ].…”

Section: Discussionsupporting

confidence: 94%

“…For instance, Cheng BC et al used ASL to study CBF changes in ESRD patients on long-term peritoneal dialysis therapy and compared CBF in ESRD patients before and after peritoneal dialysis with that of HCs; they found that ESRD patients had a mean increase in CBF compared to HCs and that higher CBF in the left hippocampus of ESRD patients was associated with worse executive function [ 19 ]. Li et al studied CBF changes in elderly adults before and after hemodialysis and found that global CBF within the gray matter and white matter was significantly higher in hemodialysis patients than in HCs, with significant local CBF increases in the hippocampus and orbitofrontal cortex [ 20 ]. These studies found CBF alterations in the hippocampus as we did, but the difference is that our study was conducted in patients with CKD4, which also suggests that alterations in CBF are already present in non-end-stage patients.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Altered Cerebral Blood Flow in the Progression of Chronic Kidney Disease

Lin

Liu

et al. 2023

JPM

View full text Add to dashboard Cite

Background: In chronic kidney disease (CKD), cognitive impairment is a definite complication. However, the mechanisms of how CKD leads to cognitive impairment are not clearly known. Methods: cerebral blood flow (CBF) information was collected from 37 patients with CKD (18 in stage 3; 19 in stage 4) and 31 healthy controls (HCs). For CKD patients, we also obtained laboratory results as well as neuropsychological tests. We conducted brain perfusion imaging studies using arterial spin labeling and calculated the relationship between regional CBF changes and various clinical indicators and neuropsychological tests. We also performed Receiver operator characteristic(ROC) curves to explore whether CBF value changes in certain brain regions have the ability to identify CKD. Results: Compared with HC, CBF was decreased in the right insula and increased in the left hippocampus in the CKD4 group; through partial correlation analysis, we found that CBF in the right insula was negatively correlated with the number connection test A (NCT-A) (r = −0.544, p = 0.024); CBF in the left hippocampus was positively correlated with BUN (r = 0.649, p = 0.005) and negatively correlated with serum calcium level (r = −0.646, p = 0.005). By comparing the ROC curve area, it demonstrated that altered CBF values in the right insula (AUC = 0.861, p < 0.01) and left hippocampus (AUC = 0.862, p < 0.01) have a good ability to identify CKD. Conclusions: Our study found that CBF alterations in the left hippocampus and the right insula brain of adult patients with stage 4 CKD correlated with disease severity or laboratory indicators. These findings provide further insight into the relationship between altered cerebral perfusion and cognitive impairment in patients with non-end-stage CKD as well as, explore the underlying neuropathophysiological mechanisms.

show abstract

Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Altered Cerebral Blood Flow in the Progression of Chronic Kidney Disease

Lin

Liu

et al. 2023

JPM

View full text Add to dashboard Cite

show abstract

“…Anemia, generally decreasing hemoglobin level, is common in HD patients. Relaxation time (T 1 ) of blood (T 1B ) varies with age and hematocrit or hemoglobin levels (11). CBF quantification results are significantly modified by the T 1B .…”

Section: Cerebral Blood Flow (Cbf) Calculationmentioning

confidence: 99%

“…To achieve rigorous CBF quantification, a singlecompartment model was used for CBF quantification (25). The hemoglobin levels of participants and the previously proposed general model were used to estimate the T 1B in this study (11,29). The hemoglobin levels of HD patients were derived from blood samples obtained during standard HD treatments; an age-and sex-dependent hemoglobin level was applied for HCs (30).…”

Section: Cerebral Blood Flow (Cbf) Calculationmentioning

confidence: 99%

“…Yi et al found that widespread impairments in corona radiata and thalamic radiations may have influenced cognitive function in ESRD patients, and serum urea levels were related to these WM changes (10). The existing literature has focused on exploring alterations in WM microstructure, but few studies have investigated visible WM alterations, such as enlarged PVS in WM regions (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Long-term hemodialysis may affect enlarged perivascular spaces in maintenance hemodialysis patients: evidence from a pilot MRI study

Wang¹,

Han²,

Li³

et al. 2022

Quant Imaging Med Surg

View full text Add to dashboard Cite

Background: Hemodialysis (HD) causes various nervous system abnormalities. Alterations in white matter (WM) microstructure after long-term HD have been reported in a few previous studies; however, no studies have been performed to investigate enlarged perivascular spaces (PVS) in WM regions. We measured cerebral blood flow (CBF) and white matter volume (WMV) in HD patients to assess enlarged PVS severity in the WM across the whole brain and suggest possible explanations for this.Methods: Fifty-one HD patients and 51 age-, sex-, and education-matched healthy controls (HCs) were recruited. The number of enlarged PVS in the centrum semiovale (CS), cerebral watershed (CW), and basal ganglia (BG) regions were assessed by T2-weighted MRI. CBF was estimated by arterial spin labeling (ASL), which is a non-invasive perfusion imaging technique. WMV was assessed by the computational anatomy toolbox (CAT12), which is a statistical analysis package. Differences in descriptive variables (two-tailed t-tests, χ 2 tests, Mann-Whitney U tests, and Friedman M tests), an intra-class correlation between radiologists, the relationship between enlarged PVS number and HD duration, normalized CBF and WMV (multiple regression), and group differences in CBF and WMV {voxel-wise t-tests with age and sex as covariates [cluster size >50 voxels, false discovery rate (FDR) corrected, P<0.05]} were assessed.Results: HD patients displayed a more significant number of CS-PVS and CW-PVS in WM regions compared with the HCs, but there was no significant difference in the number of BG-PVS. The number of CS-PVS and CW-PVS were positively associated with HD duration. The number of CW-PVS was positively associated with CBF changes and WMV alteration in HD patients. Meanwhile, significant differences in the blood pressure (BP) readings pre-HD, intra-HD, and post-HD were observed in HD patients. Compared with the HCs, the HD patients showed higher CBF in the CS, CW, and BG regions (P<0.05). Hence, decreased WMV in the CS, CW, and BG regions were shown in the HD patients compared with the HCs (P<0.05).Conclusions: Enlarged CS-PVS and CW-PVS on MRI might be a feature of long-term HD patients.

show abstract

Reduced functional connectivity induced by longitudinal alterations of structure and perfusion may be associated with cognitive impairment in patients on maintenance hemodialysis

Yang,

Li,

Song

et al. 2024

Brain Imaging and Behavior

View full text Add to dashboard Cite

Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging

Abstract: Highlights CBF declined approximately six months after hemodialysis initiation. The associations between longitudinal changes in 3MS score and regional CBF were observed. Decreased brain perfusion may contribute to the observed cognitive decline.

Cited by 13 publications

References 44 publications

Altered Cerebral Blood Flow in the Progression of Chronic Kidney Disease

Altered Cerebral Blood Flow in the Progression of Chronic Kidney Disease

Long-term hemodialysis may affect enlarged perivascular spaces in maintenance hemodialysis patients: evidence from a pilot MRI study

Reduced functional connectivity induced by longitudinal alterations of structure and perfusion may be associated with cognitive impairment in patients on maintenance hemodialysis

Contact Info

Product

Resources

About