Reduced white matter integrity and cognitive deficits in maintenance hemodialysis ESRD patients: A diffusion-tensor study

Zhang, Ruijie; Liu, Kai; Yang, Linfeng; Zhou, Tao; Qian, Shaowen; Li, Bo; Peng, Zhongmin; Li, Min; Sang, Shengpeng; Jiang, Qingjun; Sun, Gang

doi:10.1007/s00330-014-3466-5

Cited by 57 publications

(67 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diffusion-tensor imaging (DTI) studies showed that patients with ESRD have lower fractional anisotropy and increased mean diffusivity values in all white matter regions when compared with patients in a healthy control group. These results positively correlated with neuropsychologic scores (13)(14)(15)(16). In recent studies (17)(18)(19)(20) of resting-state functional MR imaging, investigators have shown abnormal brain functional connectivity, particularly in the default mode network (DMN), in patients with ESRD.…”

Section: Discussionmentioning

confidence: 51%

Brain Default Mode Network Changes after Renal Transplantation: A Diffusion-Tensor Imaging and Resting-State Functional MR Imaging Study

Zhang¹,

Wen²,

Li³

et al. 2016

Radiology

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 51%

Brain Default Mode Network Changes after Renal Transplantation: A Diffusion-Tensor Imaging and Resting-State Functional MR Imaging Study

Zhang¹,

Wen²,

Li³

et al. 2016

Radiology

View full text Add to dashboard Cite

show abstract

“…Patients with ESRD have lower FA and higher MD values[6, 10–13], which are generally associated with poorer cognitive function[8, 9, 22, 23]. Moreover, improvement in FA and MD is associated with an improvement in cognition[24].…”

Section: Discussionmentioning

confidence: 99%

“…Patients with ESRD have lower FA and higher MD values[6, 10–13]. The effect of transplantation on these DTI parameters remains unknown.…”

Section: Introductionmentioning

confidence: 99%

Cognitive Function and White Matter Changes Associated with Renal Transplantation

Gupta

Lepping

et al. 2016

Am J Nephrol

View full text Add to dashboard Cite

Background: End-stage renal disease (ESRD) is a disease with an aging population and a high prevalence of cognitive impairment affecting quality of life, health care costs and mortality. Structural changes in the brain with decreased white matter integrity have been observed in ESRD. Understanding the changes in cognition and associated changes in brain structure after renal transplantation can help define the mechanisms underlying cognitive impairment in ESRD. Methods: We conducted a prospective, observational cohort study in ESRD patients listed for renal transplantation and followed them post-transplantation. We assessed their cognitive function with a battery of neuropsychological tests and brain white matter integrity with diffusion tensor imaging (DTI) both before transplant and 3 months after transplant. Results: Eleven patients, aged 56.5 ± 10.7 years, completed the study. Cognitive measures of memory and executive function improved after the transplant, specifically on tests of logical memory I (p = 0.004), logical memory II (p = 0.003) and digit symbol (p < 0.0001). DTI metrics also improved post the transplant with an increase in fractional anisotropy (p = 0.01) and decrease in mean diffusivity (p = 0.004). These changes were more prominent in tracts associated with memory and executive function. Conclusions: Cognitive function, particularly memory and executive function, improve post the transplant with concurrent improvements in white matter integrity in tracts associated with memory and executive function. These data suggest that abnormalities in cognition and brain structure seen in the ESRD population are at least partially reversible.

show abstract

“…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.…”

Section: Resultsmentioning

confidence: 99%

“…Thirty-five out of the 46 studies were conducted in the haemodialysis population, 9 studies in both the peritoneal dialysis and haemodialysis population, and 1 in the peritoneal dialysis population. Most studies included patients aged ≥65 years, and only 2 studies were conducted focusing on a younger population, with a mean age of <40 years [35,55]. …”

Section: Resultsmentioning

confidence: 99%

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

San

Hiremagalur

Muircroft

et al. 2017

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background: Cognitive impairment in end-stage kidney disease patients on dialysis is increasingly common. This study aimed to review the practice of screening and to evaluate the evidence on cognitive impairment prevalence in this population. Methods: This scoping review of studies summarises the evidence on cognitive impairment in dialysis populations. The search included the Medline, CINAHL, Embase, PsycINFO, PubMed, and Cochrane Library databases for English-language articles published between 2000 and 2015. A total of 46 articles were reviewed. Results: The studies were of prospective observational design, with the majority conducted in the haemodialysis population. The reported prevalence of cognitive impairment ranged from 6.6 to 51%. Three screening tools were consistently used. Conclusion: While cognitive impairment is recognised in the dialysis population, there is paucity of screening data. The design of prospective comparisons ideally includes established screening instruments, particularly the Montreal Cognitive Assessment, to determine the optimal results for this population. Translation of established screening tools to increase the inclusion of people from other cultural and language groups is required. Regular screening can enhance the timing to introduce home-based care support and advance care planning discussions.

show abstract

Reduced white matter integrity and cognitive deficits in maintenance hemodialysis ESRD patients: A diffusion-tensor study

Abstract: Structural damages to radiation and associative fibre tracts, caused by brain oedema and WM demyelination, may account for the cognitive deficits in ESRD patients.

Cited by 57 publications

References 33 publications

Brain Default Mode Network Changes after Renal Transplantation: A Diffusion-Tensor Imaging and Resting-State Functional MR Imaging Study

Brain Default Mode Network Changes after Renal Transplantation: A Diffusion-Tensor Imaging and Resting-State Functional MR Imaging Study

Cognitive Function and White Matter Changes Associated with Renal Transplantation

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

Contact Info

Product

Resources

About