Differential activation of memory-relevant brain regions during a dialysis cycle

Abstract

Cognitive impairment is a common and largely undiagnosed finding in a significant number of dialysis patients. These alterations may result from concomitant cerebrovascular disease, hemodynamic instability, the uremic milieu, or changes induced by the dialysis process. In order to gain further insight into this, we recruited 12 stable chronic hemodialysis patients (without clinical neurological disease) and an age- and gender-matched cohort of 12 control individuals (without renal or neurological problems) in a prospective, single-center study. In order to disentangle the influence of dialysis itself on memory function, each dialysis patient was tested twice: once immediately before dialysis following a long weekend (t1) and again the day after this dialysis (t2). The control individuals were tested in the same time frame. Neuropsychological testing found that the control individuals performed significantly better in verbal learning, motor speed, task switching, verbal comprehension, word fluency, spatial visualization, spatial perception, and reasoning; all independent of the time point. Functional magnetic resonance imaging of the whole brain in seven hemodialysis patients found significantly more bilateral activation of the hippocampus during the verbal working memory task at t2 relative to t1 compared with their seven matched control counterparts. Thus, our study found differential and task-specific activation of memory-relevant brain areas during a dialysis cycle.

Cognitive Function Declines Significantly during Haemodialysis in a Majority of Patients: A Call for Further Research

“…These changes were more prominent in haemodialysis patients compared to non-dialysed end-stage kidney disease patients and correlated with CI, pre-dialysis serum creatinine and duration of haemodialysis [45-46]. Another functional MRI study of the whole brain in haemodialysis patients showed bilateral activation of hippocampus suggesting activation of memory-relevant brain areas during dialysis [47]. These conclusions suggest that the haemodialysis process may have a role in CI.…”

The Impact of Inflammation on Cognitive Impairment in Chronic Kidney Disease Patients

“…The results of this study indicated that cognitive impairment is reversible by HD and increasing the HD frequency could induce beneficial effects on patients' cognitive function [68]. In the literature, there is an agreement that HD therapy improves cognitive function in CKD patients [69,70]. Although, it is well known that cognitive function is believed to be best 24 hours after the HD session, the variation of cognitive function during the HD circle has not been investigated yet.…”

Screening of Cognitive Impairment in the Dialysis Population: A Scoping Review

“…There were 46 studies meeting the inclusion criteria for final analysis [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]. An overview of the reviewed articles is presented in Table 2.…”