Yen-Ling Chiu1, Hsiu-Hui Tsai2, Yen-Jun Lai2, Hsin-Yi Tseng3, Yen-Wen Wu4, Yu-Sen Peng5, Cheng-Ming Chiu6, Yi-Fang Chuang7. 1. Department of Nephrology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Graduate Program in Biomedical Informatics, Yuan Ze University, Taoyuan, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University, Taipei, Taiwan; Health Management Center, Far Eastern Memorial Hospital, New Taipei, Taiwan. 2. Division of Medical Imaging, Radiology, Far Eastern Memorial Hospital, New Taipei, Taiwan. 3. Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan. 4. Department of Cardiology, Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei, Taiwan. 5. Department of Nephrology, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Electrical Engineering, Yuan Ze University, Taoyuan, Taiwan. 6. Health Management Center, Far Eastern Memorial Hospital, New Taipei, Taiwan. 7. Institute of Public Health, School of Medicine, National Yang Ming University, Taipei, Taiwan; Preventive Medicine Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address: chuangy@ym.edu.tw.
Abstract
BACKGROUND: Chronic kidney disease exhibits a prominent premature aging phenotype in many different organ systems, including the brain. Nevertheless, a comprehensive characterization of brain aging in non-demented patients with end-stage renal disease (ESRD) is lacking and it remains unclear if the collective changes of cognitive functions and brain structures in ESRD is compatible with aging. METHODS: We compared 56 non-demented, independently living dialysis patients (mean age 59.4 ± 11.0 years; mean dialysis vintage of 5.9 years) and 60 non-dialysis controls on a battery of neuropsychological tests, brain MRI T1 imaging and diffusion tensor imaging. Participants with diagnosis of dementia, Mini-Mental State Examination <24, medical history of stroke, or recent hospitalization within 1 month were excluded. RESULTS: Dialysis patients showed significantly worse performance in attention/information processing speed and executive function adjusted for age, sex, education, diabetes and depression. Reduced total brain volume and subcortical volume including hippocampus were found in dialysis patients. Vertex-wise analysis showed cortical thinning in middle frontal, lateral occipital and precuneus region. Furthermore, decreased white matter integrity was found primarily in bilateral anterior thalamic tract, fronto-occipital fasciculus, forceps minor and uncinate tract after correction for multiple comparisons. CONCLUSION: Overall, differences in cognitive functions, cortical volumes/thickness and white matter integrity associated with dialysis are also cognitive domains and brain structure changes associated with normal aging. In other words, non-demented, independently living dialysis patients present an accelerated brain aging phenotype even after taking into account effects of age, diabetes and depression.
BACKGROUND:Chronic kidney disease exhibits a prominent premature aging phenotype in many different organ systems, including the brain. Nevertheless, a comprehensive characterization of brain aging in non-demented patients with end-stage renal disease (ESRD) is lacking and it remains unclear if the collective changes of cognitive functions and brain structures in ESRD is compatible with aging. METHODS: We compared 56 non-demented, independently living dialysis patients (mean age 59.4 ± 11.0 years; mean dialysis vintage of 5.9 years) and 60 non-dialysis controls on a battery of neuropsychological tests, brain MRI T1 imaging and diffusion tensor imaging. Participants with diagnosis of dementia, Mini-Mental State Examination <24, medical history of stroke, or recent hospitalization within 1 month were excluded. RESULTS: Dialysis patients showed significantly worse performance in attention/information processing speed and executive function adjusted for age, sex, education, diabetes and depression. Reduced total brain volume and subcortical volume including hippocampus were found in dialysis patients. Vertex-wise analysis showed cortical thinning in middle frontal, lateral occipital and precuneus region. Furthermore, decreased white matter integrity was found primarily in bilateral anterior thalamic tract, fronto-occipital fasciculus, forceps minor and uncinate tract after correction for multiple comparisons. CONCLUSION: Overall, differences in cognitive functions, cortical volumes/thickness and white matter integrity associated with dialysis are also cognitive domains and brain structure changes associated with normal aging. In other words, non-demented, independently living dialysis patients present an accelerated brain aging phenotype even after taking into account effects of age, diabetes and depression.
Authors: Aleksandra Mańkowska; Kenneth M Heilman; Bogdan Biedunkiewicz; Alicja Dębska-Ślizień; John B Williamson; Michał Harciarek Journal: Brain Sci Date: 2021-11-23