Decreased cerebral blood flow and improved cognitive function in patients with end-stage renal disease after peritoneal dialysis: An arterial spin-labelling study
Creators
- 1. Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Nephrology (China)
- 2. Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Physical Medicine and Rehabilitation (China)
- 3. Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Diagnostic Radiology (China)
- 4. Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Neurology (China)
- 5. National Yang-Ming University, Brain Research Center (China)
- 6. Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Department of Internal Medicine (China)
Description
Objectives
The aim of this study was to evaluate the relationship between cognitive impairment and brain perfusion using arterial spin labelling (ASL) in end-stage renal disease (ESRD) patients undergoing PD.Methods
ESRD patients undergoing PD were recruited. Laboratory screening, neuropsychological tests and ASL magnetic resonance imaging (MRI) were conducted prior to and after 6 months of PD. Age- and sex-matched normal subjects without ESRD served as the control group. Comparisons of regional CBF between ESRD patients before or after undergoing PD and normal controls were performed. Correlations between biochemical, neuropsychological and CBF data were also conducted to evaluate the relationships.
Results
ESRD patients showed poor performance in many of the neuropsychological tests; PD improved cognition in some domains. Pre-PD patients had higher mean CBF than post-PD patients and normal controls, but no significant difference was found between the normal controls and post-PD patients. Negative correlations were observed pre-PD (regional CBF in left hippocampus vs. perseverative responses, r = -0.662, p = 0.014), post-PD (mean CBF vs. haemoglobin level, r = -0.766, p = 0.002), and before and after PD (change in CBF in the left putamen vs. change in haematocrit percentage, r = -0.808, p = 0.001).
Conclusion
Before PD, ESRD patients had increased cerebral perfusion that was related to poorer executive function, especially in the left hippocampus. Post-PD patients performed better in some cognitive test domains than pre-PD patients. The degree of anaemia, i.e., haemoglobin level or haematocrit percentage, might predict cognitive impairment in PD patients.
Key Points
• In this study, ESRD patients before PD had cerebral hyperperfusion that was related to poorer executive function.
• Post-PD patients performed better in some cognitive test domains than pre-PD patients did.
• The degree of anaemia might predict cognitive impairment in PD patients.
Additional details
Identifiers
Publishing Information
- Journal Title
- European Radiology
- Journal Volume
- 29
- Journal Issue
- 3
- Journal Page Range
- p. 1415-1424
- ISSN
- 0938-7994
- CODEN
- EURAE3
INIS
- Country of Publication
- Germany
- Country of Input or Organization
- International Atomic Energy Agency (IAEA)
- INIS RN
- 54094768
- Subject category
- S62: RADIOLOGY AND NUCLEAR MEDICINE;
- Descriptors DEI
- ARTERIES; BLOOD FLOW; DIALYSIS; HEMOGLOBIN; HIPPOCAMPUS; KIDNEYS; MAGNETIC RESONANCE; NMR IMAGING; PATIENTS
- Descriptors DEC
- BLOOD VESSELS; BODY; BRAIN; CARBOXYLIC ACIDS; CARDIOVASCULAR SYSTEM; CENTRAL NERVOUS SYSTEM; DIAGNOSTIC TECHNIQUES; GLOBINS; HETEROCYCLIC ACIDS; HETEROCYCLIC COMPOUNDS; NERVOUS SYSTEM; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; ORGANS; PIGMENTS; PORPHYRINS; PROTEINS; RESONANCE; SEPARATION PROCESSES
Optional Information
- Copyright
- Copyright (c) 2018 The Author(s)