AN OBSERVATIONAL STUDY OF SUBCLINCAL ISCHEMIC BRAIN DISEASE AND COGNITIVE DYS

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 美国有800万慢性肾脏疾病(CKD)患者，他们患有明显的功能障碍，患痴呆症和认知功能障碍的风险极高。虽然CKD也与血管疾病的发生率增加有关，但脑缺血在导致这种认知损害中的作用尚不清楚。在没有肾脏疾病的个体中，核医学技术检测到的脑血流受损(CBF)最近被发现与认知障碍和认知下降密切相关，并与普遍存在的心血管危险因素有关。然而，在慢性肾脏病患者中，脑低灌注与认知功能障碍之间的关系尚未得到评估。我们建议使用单光子发射计算机断层扫描(SPECT)测量患有中晚期慢性肾脏疾病的老年人(65岁)的脑血流量。我们将通过与DEPTS的Shari Waldstein博士合作，将这些测量与先前收集的年龄相似的无肾脏疾病的高血压患者的CBF数据进行比较，以检验肾功能和脑低灌注之间的联系。心理学和医学系。此外，我们将把这些CBF测量与脑MRI和认知功能数据结合起来，作为NIH资助的研究职业发展奖的一部分，在CKD研究人群中收集，并将作为UMB胡椒中心研究开发核心试点资助的一部分收集身体功能测量。我们将研究CKD患者的脑血流灌注、神经认知和身体功能以及MRI定义的缺血性脑损伤之间的相互关系。这些分析是确定CKD患者保留大脑功能的机会的第一步。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. There are 8 million individuals in the US with Chronic Kidney Disease (CKD), who suffer from marked functional impairment and an extraordinarily high risk of dementia and cognitive dysfunction. Although CKD is also associated with an increased rate of vascular disease, the role of brain ischemia in contributing to this cognitive impairment is unknown. In individuals without kidney disease, impaired cerebral blood flow (CBF) - as detected by nuclear medicine techniques - has been recently identified as a strong correlate of cognitive impairment and cognitive decline, and is associated with prevalent cardiovascular risk factors. However, the relationship between cerebral hypoperfusion and cognitive dysfunction has not been assessed in CKD. We are proposing to measure cerebral blood flow in a population of older adults (age>65) with moderate-advanced chronic kidney disease using single-photon emission computed tomography (SPECT). We will examine the association between renal function and cerebral hypoperfusion by comparing these measures with previously collected CBF data in age-similar hypertensives without kidney disease, through collaboration with Dr. Shari Waldstein of the Depts. of Psychology and Medicine. Additionally, we will combine these CBF measurements with brain MRI and cognitive function data to be collected in the CKD study population as part of an NIH-funded Research Career Development Award, and measures of physical function to be collected as part of a UMB Pepper Center Research Development Core Pilot Grant. We will examine the inter-relationship among cerebral perfusion, neurocognitive and physical function, and MRI-defined ischemic brain damage in CKD. These analyses are the first steps towards identifying opportunities to preserve brain function in individuals with CKD.