Regional high iron deposition on brain quantitative susceptibility mapping correlates with cognitive decline in chronic kidney disease patients

Abstract

Objective Evaluate the changes of gray matter nuclei iron deposition in chronic kidney disease (CKD) patients by quantitative susceptibility mapping (QSM) threshold method and analyze the relationship between brain iron and cognitive function. Materials and Methods Prospectively recruited CKD patients with and without hemodialysis (HD and NHD), and healthy controls (HCs). Compared neuropsychological scores, clinical indexes and QSM data among three groups. Analyzed correlation between QSM data with neuropsychological scores and laboratory index in HD group. Used linear regression analysis to explore the effect of iron deposition on cognition and emotion in HD group. A statistically significant P-value was set at 0.05. Results 96 individuals were recruited, including 35 HD patients (57.54 ± 10.42 years, 21 males), 18 NHD patients (55.06 ± 11.47 years, 10 males) and 43 HCs (55.67 ± 7.79 years, 18 males). Right RN mean-MSV increased in HD patients than HCs (P = 0.006). Left CN, bilateral Put and right RN high-MSV were significantly different among three groups (all P = 0.027, FDR-correction). Left Put high-MSV was positively correlated with Cre and UA, right Put high-MSV was negatively correlated with MCH and MCHC. High-MSV of some nuclei were negatively correlated with cognition. Regression analysis showed iron deposition in some nuclei were independent risk factors of depression and orientation ability. Conclusion Brain iron deposition is excessive and uneven in CKD patients, especially undergoing hemodialysis. Regional high-iron deposition can better assess the distribution of iron, which is related to the cognitive dysfunction and emotional disorder.