Cognitive Impairment in Chronic Kidney Disease Is Associated with Glymphatic System Dysfunction

被引:7
作者
Xu, Shuqin [1 ,2 ]
Wang, Jiuqi [1 ,2 ]
Sun, Kedi [1 ,2 ]
Meng, Lin [1 ,2 ]
Qin, Chi [1 ,2 ]
Feng, Renyi [1 ,2 ]
Tian, Yiming [1 ,2 ]
Zhai, Yanping [1 ,2 ]
Liang, Dongxiao [1 ,2 ]
Zhang, Rui [1 ,2 ]
Tian, Haiyan [1 ,2 ]
Liu, Han [1 ,2 ]
Chen, Yongkang [1 ,2 ]
Fu, Yu [1 ,2 ]
Chen, Pei [1 ,2 ]
Zhu, Qingyong [1 ,2 ]
Teng, Junfang [1 ,2 ]
Wang, Xuejing [1 ,2 ]
机构
[1] Zhengzhou Univ, Affiliated Hosp 1, Dept Neurol, Zhengzhou, Peoples R China
[2] Zhengzhou Univ, Inst Parkinson & Movement Disorder, Zhengzhou, Peoples R China
基金
中国国家自然科学基金;
关键词
Glymphatic system; Perivascular spaces; Magnetic resonance imaging; Chronic kidney disease; Cognitive impairment; CEREBRAL MICROBLEEDS; PERIVASCULAR SPACES; DIABETES-MELLITUS; HEMODIALYSIS; DIALYSIS; DEPRESSION;
D O I
10.1159/000530635
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Introduction: This study was designed to explore the associations between impaired cognition in chronic kidney disease (CKD) patients and the dysfunction of the glymphatic system. Method: Data were obtained from 77 CKD patients and 50 age-matched healthy control individuals from the First Affiliated Hospital of Zhengzhou University. CKD patients were stratified into with and without impaired cognitive function. T2-weighted magnetic resonance imaging results were used to assess area ratios for the perivascular space and ventricles in participants, while the Montreal Cognitive Assessment and the Mini-Mental State Examination were employed to measure cognitive function. Correlations between the perivascular space or ventricle area ratios and cognitive impairment were assessed in CKD patients. Results: Significant increases in the burden of enlarged perivascular spaces in the frontal cortex and basal ganglia were observed in CKD patients with cognitive impairment relative to those without such impairment, with a concomitant increase in analyzed ventricle area ratios. Enlarged perivascular spaces in the frontal cortex, basal ganglia and increased area ratios of lateral ventricles and 4th ventricle exhibited relatively high sensitivity and specificity as means of differing between the CKD patients with and without cognitive impairment. Conclusion: These results indicate that the burden of enlarged perivascular spaces in the frontal cortex and basal ganglia and increases in ventricle area ratio values may offer utility as biomarkers that can aid in detection of even mild cognitive decline in individuals with CKD. The dysfunction of the glymphatic system may play a key role in the pathogenesis of CKD-related cognitive impairment.
引用
收藏
页码:384 / 397
页数:14
相关论文
共 45 条
  • [1] Association of Cerebral Microbleeds With Cognitive Decline and Dementia
    Akoudad, Saloua
    Wolters, Frank J.
    Viswanathan, Anand
    de Bruijn, Renee F.
    van der Lugt, Aad
    Hofman, Albert
    Koudstaal, Peter J.
    Ikram, M. Arfan
    Vernooij, Meike W.
    [J]. JAMA NEUROLOGY, 2016, 73 (08) : 934 - 943
  • [2] Expression of Aquaporin-1,-2 and -4 in Mice with a Spontaneous Mutation Leading to Hydronephrosis
    Ampawong, S.
    Klincomhum, A.
    Likitsuntonwong, W.
    Singha, O.
    Ketjareon, T.
    Panavechkijkul, Y.
    Zaw, K. -M.
    Kengkoom, K.
    [J]. JOURNAL OF COMPARATIVE PATHOLOGY, 2012, 146 (04) : 332 - 337
  • [3] Physiology and Clinical Relevance of Enlarged Perivascular Spaces in the Aging Brain
    Bown, Corey W.
    Carare, Roxana O.
    Schrag, Matthew S.
    Jefferson, Angela L.
    [J]. NEUROLOGY, 2022, 98 (03) : 107 - 117
  • [4] Increased Number and Distribution of Cerebral Microbleeds Is a Risk Factor for Cognitive Dysfunction in Hemodialysis Patients A Longitudinal Study
    Chai, Chao
    Wang, Zhiye
    Fan, Linlin
    Zhang, Mengjie
    Chu, Zhiqiang
    Zuo, Chao
    Liu, Lei
    Haacke, E. Mark
    Guo, Wenmei
    Shen, Wen
    Xia, Shuang
    [J]. MEDICINE, 2016, 95 (12)
  • [5] Cognitive impairment and hippocampal atrophy in chronic kidney disease
    Chang, C. -Y.
    Lin, C. -C.
    Tsai, C. -F.
    Yang, W. -C.
    Wang, S. -J.
    Lin, F. -H.
    Fuh, J. -L.
    [J]. ACTA NEUROLOGICA SCANDINAVICA, 2017, 136 (05): : 477 - 485
  • [6] Re-Establishing Brain Networks in Patients with ESRD after Successful Kidney Transplantation (Publication with Expression of Concern. See vol. 14, pg. 1072, 2019)
    Chen, Hui Juan
    Wen, Jiqiu
    Qi, Rongfeng
    Zhong, Jianhui
    Schoepf, U. Joseph
    Varga-Szemes, Akos
    Lesslie, Virginia W.
    Kong, Xiang
    Wang, Yun Fei
    Xu, Qiang
    Zhang, Zhe
    Li, Xue
    Lu, Guang Ming
    Zhang, Long Jiang
    [J]. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2018, 13 (01): : 109 - 117
  • [7] Cognitive impairment in chronic kidney disease: keep vascular disease in mind
    Drew, David A.
    Weiner, Daniel E.
    [J]. KIDNEY INTERNATIONAL, 2014, 85 (03) : 505 - 507
  • [8] Gene silencing of endothelial von Willebrand Factor attenuates angiotensin II-induced endothelin-1 expression in porcine aortic endothelial cells
    Dushpanova, Anar
    Agostini, Silvia
    Ciofini, Enrica
    Cabiati, Manuela
    Casieri, Valentina
    Matteucci, Marco
    Del Ry, Silvia
    Clerico, Aldo
    Berti, Sergio
    Lionetti, Vincenzo
    [J]. SCIENTIFIC REPORTS, 2016, 6
  • [9] MINI-MENTAL STATE - PRACTICAL METHOD FOR GRADING COGNITIVE STATE OF PATIENTS FOR CLINICIAN
    FOLSTEIN, MF
    FOLSTEIN, SE
    MCHUGH, PR
    [J]. JOURNAL OF PSYCHIATRIC RESEARCH, 1975, 12 (03) : 189 - 198
  • [10] Brain Magnetic Resonance Imaging Findings in Children and Young Adults With CKD
    Hartung, Erum A.
    Erus, Guray
    Jawad, Abbas F.
    Laney, Nina
    Doshi, Jimit J.
    Hooper, Stephen R.
    Radcliffe, Jerilynn
    Davatzikos, Christos
    Furth, Susan L.
    [J]. AMERICAN JOURNAL OF KIDNEY DISEASES, 2018, 72 (03) : 349 - 359