Brain Magnetic Resonance Imaging Findings in Children and Young Adults With CKD.
Brain Magnetic Resonance Imaging Findings in Children and Young Adults With CKD.
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CKD儿童和年轻人的脑磁共振成像发现。
DOI：
10.1053/j.ajkd.2017.11.024
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发表时间：
2018-09
期刊：
影响因子：
--
通讯作者：
Furth SL
中科院分区：
文献类型：
--
作者：
Hartung EA;Erus G;Jawad AF;Laney N;Doshi JJ;Hooper SR;Radcliffe J;Davatzikos C;Furth SL
慢性肾脏疾病（CKD）认知障碍的神经解剖学基础尚未完全确定。我们采用先进的定量结构磁共振成像（MRI）来确定CKD是否影响大脑结构，以及CKD患者较差的神经认知表现是否与大脑结构差异有关。横截面。85例CKD 2-5期患者和63例健康对照者，年龄8-25岁CKD与对照组，估计肾小球滤过率（eGFR）和肾移植状态作为MRI结果的预测因子进行了分析。分析灰质（GM）、白质（WM）和脑脊液的19个预先指定区域的MRI体积，作为7个预先指定区域的神经认知表现（中位数z分数）的预测因子。在7个预先指定的领域中，有19个预先指定的大脑兴趣区域（roi）。在7个预先指定的领域的神经认知表现。使用未调整t检验和协方差分析（ANCOVA）比较CKD与对照组的ROI体积。使用ANCOVA和线性回归分析CKD参与者的ROI体积与eGFR和肾移植状态的关联。通过线性回归分析神经认知表现与ROI体积的关系。在未调整分析中，CKD参与者的全脑、皮质和左顶叶GM体积低于对照组，但在调整分析中没有发现差异。在CKD参与者中，较低的eGFR与全脑（P=0.05）和额叶roi （P=0.04）较高的WM体积相关，但经多次比较校正后差异不显著。肾移植受者全脑GM体积（P=0.01， Q=0.06）、额叶GM体积（P=0.02， Q=0.08）、左右顶叶GM体积（P=0.01， Q=0.06和P=0.03， Q=0.1）和全脑WM体积（P=0.04， Q=0.1）均较低。CKD组的神经认知表现与ROI量无关。无法评估脑结构和肾功能随时间的变化；分析仅限于预先指定的roi和神经认知领域。在一些roi中，儿童和年轻人的CKD可能与较低的GM体积和较高的WM体积有关。整体而言，CKD组的差异相对较小，但在肾移植患者中差异更为明显。然而，神经认知表现不能用脑ROI体积的差异来解释，这表明CKD神经认知障碍的功能基础而不是结构基础。
The neuroanatomic basis for cognitive impairment in chronic kidney disease (CKD) is incompletely characterized. We performed advanced quantitative structural magnetic resonance imaging (MRI) to determine whether CKD affects brain structure, and whether poorer neurocognitive performance in CKD is associated with structural brain differences. Cross-sectional. 85 individuals with CKD Stage 2–5 and 63 healthy controls, aged 8–25 years CKD vs. control, estimated glomerular filtration rate (eGFR), and kidney transplant status were analyzed as predictors of MRI findings. MRI volumes in 19 pre-specified regions of gray matter (GM), white matter (WM), and cerebrospinal fluidwere analyzed as predictors of neurocognitive performance (median z scores) in 7 pre-specified domains. Nineteen pre-specified brain regions of interest (ROIs) in 7 pre-specified domains. Neurocognitive performance in 7 pre-specified domains. ROI volumes were compared in CKD vs. controls using unadjusted t-tests and analysis of covariance (ANCOVA). Associations of ROI volumes with eGFR and kidney transplant status in CKD participants were analyzed using ANCOVA and linear regression. Associations of neurocognitive performance and ROI volumes were analyzed by linear regression. CKD participants had lower whole-brain, cortical, and left parietal GM volumes than controls in unadjusted analyses, but no differences were found in adjusted analysis. In CKD participants, lower eGFR was associated with higher WM volume in whole brain (P=0.05) and frontal (P=0.04) ROIs, but differences were not significant after multiple comparisons correction. Kidney transplant recipients had lower GM volumes in whole brain (P=0.01, Q=0.06), frontal (P=0.02, Q=0.08), and left and right parietal (P=0.01, Q=0.06 and P=0.03, Q=0.1) ROIs, and higher whole-brain WM volume (P=0.04, Q=0.1). Neurocognitive performance in the CKD group was not associated with ROI volumes. Unable to assess changes in brain structure and kidney function over time; analysis limited to pre-specified ROIs and neurocognitive domains. CKD in children and young adults may be associated with lower GM volumes and higher WM volumes in some ROIs. Differences were relatively subtle in the CKD group as a whole, but were more prominent in recipients of a kidney transplant. However, neurocognitive performance was not explained by differences in brain ROI volumes, suggesting a functional rather than structural basis for neurocognitive impairment in CKD.
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DOI：
10.2215/cjn.09751110
发表时间：
2011-08-01
影响因子：
9.8
作者：
Hooper, Stephen R.;Gerson, Arlene C.;Warady, Bradley A.
通讯作者：
Warady, Bradley A.
影响因子：
2.4
作者：
Gelb, Shannon R.;Shapiro, R. J.;Thornton, W. J. L.
通讯作者：
Thornton, W. J. L.
影响因子：
2.5
作者：
Gur, RC;Alsop, D;Gur, RE
通讯作者：
Gur, RE
影响因子：
4.8
作者：
Doshi, Jimit;Erus, Guray;Ou, Yangming;Gaonkar, Bilwaj;Davatzikos, Christos
通讯作者：
Davatzikos, Christos
影响因子：
5.7
作者：
Doshi J;Erus G;Ou Y;Resnick SM;Gur RC;Gur RE;Satterthwaite TD;Furth S;Davatzikos C;Alzheimer's Neuroimaging Initiative
通讯作者：
Alzheimer's Neuroimaging Initiative