Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging.
Arterial spin labeling (ASL)
End-stage renal disease (ESRD)
Hemodialysis
Magnetic resonance imaging (MRI)
Perfusion or cerebral blood flow (CBF)
Journal
NeuroImage. Clinical
ISSN: 2213-1582
Titre abrégé: Neuroimage Clin
Pays: Netherlands
ID NLM: 101597070
Informations de publication
Date de publication:
2020
2020
Historique:
received:
22
10
2019
revised:
09
09
2020
accepted:
10
09
2020
pubmed:
28
9
2020
medline:
29
6
2021
entrez:
27
9
2020
Statut:
ppublish
Résumé
To investigate cerebral blood flow (CBF) characteristics before and after hemodialysis initiation and their longitudinal associations with global cognitive function in older adults. A cohort of 17 older end-stage renal disease patients anticipating standard thrice-weekly hemodialysis and a group of 11 age- and sex-matched healthy control volunteers were recruited for brain perfusion imaging studies using arterial spin labeling. Hemodialysis patients participated in a prospective longitudinal study using brain magnetic resonance imaging and global cognitive assessment using the Modified Mini-Mental State Examination (3MS) at two time points: baseline, 2.9 ± 0.9 months before, and follow-up, 6.4 ± 2.4 months after hemodialysis initiation. Healthy controls were imaged once using the same protocol. CBF analyses were performed globally in grey and white matter and regionally in the hippocampus and orbitofrontal cortex. Covariate-adjusted linear mixed-effects models were used for statistical analyses (significance: p < 0.05; marginal significance: p < 0.1). At baseline, global and regional CBF was significantly higher in hemodialysis patients than in healthy controls. However, after approximately 6 months of hemodialysis, CBF declined substantially in hemodialysis patients, and became comparable to those in healthy controls. Specifically, in the hemodialysis patients, CBF declined non-significantly globally for grey and white matter and significantly regionally in the hippocampus and orbitofrontal cortex. Marginally significant associations were observed between 3MS scores and regional CBF measurements in the hippocampus and orbitofrontal cortex at baseline and follow-up, and between longitudinal changes. The significant decline in CBF after hemodialysis initiation and the observed association between longitudinal changes in regional CBF and 3MS scores suggest that decreased brain perfusion may contribute to the observed cognitive decline.
Identifiants
pubmed: 32980601
pii: S2213-1582(20)30271-0
doi: 10.1016/j.nicl.2020.102434
pmc: PMC7522859
pii:
doi:
Substances chimiques
Spin Labels
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
102434Subventions
Organisme : NIBIB NIH HHS
ID : P41 EB027061
Pays : United States
Organisme : NIBIB NIH HHS
ID : P41 EB015894
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR002494
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000114
Pays : United States
Organisme : NIA NIH HHS
ID : RF1 AG058729
Pays : United States
Informations de copyright
Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.
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