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Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging
PURPOSE: To investigate cerebral blood flow (CBF) characteristics before and after hemodialysis initiation and their longitudinal associations with global cognitive function in older adults. METHODS: A cohort of 17 older end-stage renal disease patients anticipating standard thrice-weekly hemodialys...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522859/ https://www.ncbi.nlm.nih.gov/pubmed/32980601 http://dx.doi.org/10.1016/j.nicl.2020.102434 |
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author | Li, Xiufeng Slinin, Yelena X. Zhang, Lin Dengel, Donald R. Tupper, David Metzger, Gregory J. Murray, Anne M. |
author_facet | Li, Xiufeng Slinin, Yelena X. Zhang, Lin Dengel, Donald R. Tupper, David Metzger, Gregory J. Murray, Anne M. |
author_sort | Li, Xiufeng |
collection | PubMed |
description | PURPOSE: To investigate cerebral blood flow (CBF) characteristics before and after hemodialysis initiation and their longitudinal associations with global cognitive function in older adults. METHODS: 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). RESULTS: 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. CONCLUSION: 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. |
format | Online Article Text |
id | pubmed-7522859 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-75228592020-10-02 Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging Li, Xiufeng Slinin, Yelena X. Zhang, Lin Dengel, Donald R. Tupper, David Metzger, Gregory J. Murray, Anne M. Neuroimage Clin Regular Article PURPOSE: To investigate cerebral blood flow (CBF) characteristics before and after hemodialysis initiation and their longitudinal associations with global cognitive function in older adults. METHODS: 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). RESULTS: 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. CONCLUSION: 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. Elsevier 2020-09-15 /pmc/articles/PMC7522859/ /pubmed/32980601 http://dx.doi.org/10.1016/j.nicl.2020.102434 Text en © 2020 The Authors http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Regular Article Li, Xiufeng Slinin, Yelena X. Zhang, Lin Dengel, Donald R. Tupper, David Metzger, Gregory J. Murray, Anne M. Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging |
title | Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging |
title_full | Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging |
title_fullStr | Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging |
title_full_unstemmed | Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging |
title_short | Cerebral blood flow characteristics following hemodialysis initiation in older adults: A prospective longitudinal pilot study using arterial spin labeling imaging |
title_sort | cerebral blood flow characteristics following hemodialysis initiation in older adults: a prospective longitudinal pilot study using arterial spin labeling imaging |
topic | Regular Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7522859/ https://www.ncbi.nlm.nih.gov/pubmed/32980601 http://dx.doi.org/10.1016/j.nicl.2020.102434 |
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