Changes in Cerebral Volume and White Matter Integrity in Adults on Hemodialysis and Relationship to Cognitive Function.
Changes in Cerebral Volume and White Matter Integrity in Adults on Hemodialysis and Relationship to Cognitive Function.
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作者：
Richerson WT;Umfleet LG;Schmit BD;Wolfgram DF
接受血液透析（HD）的患者存在显著的认知障碍负担。与健康对照组相比，描述HD患者的脑结构变化，并评估HD患者脑结构完整性与认知能力的关系，有助于阐明HD患者认知功能障碍的病理生理学。在这项横断面研究中，中心内≥50岁的HD患者接受了脑结构和弥散MRI，并使用NIH工具箱认知组合进行了认知评估。将HD参与者的脑成像测量与年龄匹配的对照组的成像进行比较。在两个队列中测量通过扩散张量成像参数（包括各向异性分数，FA）确定的灰质体积、白色物质体积和白色物质完整性，以确定HD参与者和健康对照者之间的大脑结构差异。使用多元线性回归模型评估NIH工具箱认知成套测验的认知表现与脑结构完整性之间的关联。我们比较了23名HD参与者和15名年龄匹配的对照者的成像测量结果。与健康对照组相比，HD参与者的灰质体积减少（526.8 cm 3 vs 589.5 cm 3，p<0.01），整体白色完整性恶化（FA值为0.2864 vs 0.3441，p<0.01），主要白色束内也是如此。左侧上级纵束的白色完整性降低与较低的执行功能评分相关（r2=0.24，p=0.02），而下纵束与较低的记忆评分相关（左侧r=0.25和p=0.03，右侧r2=0.21和p=0.03）。与对照组相比，HD患者具有白色物质完整性降低和灰质萎缩的模式。白色完整性降低与HD人群中认知能力下降相关。
Patients on hemodialysis (HD) have a significant burden of cognitive impairment. Characterizing the cerebral structural changes in HD patients compared to healthy controls and evaluating the relationship of cerebral structural integrity with cognitive performance in HD patients can help clarify the pathophysiology of the cognitive impairment in HD patients. In this cross-sectional study, in-center HD patients ≥50 years of age underwent brain structural and diffusion MRIs and cognitive assessment using NIH toolbox cognition battery. The cerebral imaging measures of the HD participants were compared to imaging from age matched controls. Gray matter volume, white matter volume and white matter integrity determined by diffusion tensor imaging parameters (including Fractional Anisotropy, FA) were measured in both cohorts to determine differences in the cerebral structure between HD participants and healthy controls. The association between cognitive performance on NIH toolbox cognition battery and cerebral structural integrity was evaluated using multiple linear regression models. We compared imaging measures form 23 HD participants and 15 age-matched controls. The HD participants had decreased gray matter volumes (526.8cm3 vs 589.5cm3, p<0.01) and worsened white matter integrity overall (FA values of 0.2864 vs 0.3441, p<0.01) and within major white matter tracts compared to healthy controls. Decreases in white matter integrity in the left superior longitudinal fasciculus was associated with lower executive function scores (r2=0.24, p=0.02) and inferior longitudinal fasciculus with lower memory scores (r=0.25 and p=0.03 for left and r2=0.21 and p=0.03 for right). HD patients have a pattern of decreased white matter integrity and gray matter atrophy compared to controls. Decreases in white matter integrity were associated with decreased cognitive performance in the HD population.
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影响因子：
5.7
作者：
de Groot M;Vernooij MW;Klein S;Ikram MA;Vos FM;Smith SM;Niessen WJ;Andersson JL
通讯作者：
Andersson JL
DOI：
10.1053/j.ajkd.2012.08.035
发表时间：
2013-02
期刊：
American journal of kidney diseases : the official journal of the National Kidney Foundation
影响因子：
--
作者：
Drew DA;Bhadelia R;Tighiouart H;Novak V;Scott TM;Lou KV;Shaffi K;Weiner DE;Sarnak MJ
通讯作者：
Sarnak MJ
影响因子：
5.7
作者：
Bach, Michael;Laun, Frederik B.;Maier-Hein, Klaus H.
通讯作者：
Maier-Hein, Klaus H.
影响因子：
5.7
作者：
Diedrichsen, Joern;Balsters, Joshua H.;Ramnani, Narender
通讯作者：
Ramnani, Narender
影响因子：
17.7
作者：
Frazier, JA;Chiu, SF;Biederman, J
通讯作者：
Biederman, J