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European Radiology
Published in: European Radiology 3/2019

Open Access 01-03-2019 | Magnetic Resonance

Decreased cerebral blood flow and improved cognitive function in patients with end-stage renal disease after peritoneal dialysis: An arterial spin-labelling study

Authors: Ben-Chung Cheng, Po-Cheng Chen, Pei-Chin Chen, Cheng-Hsien Lu, Yu-Chi Huang, Kun-Hsien Chou, Shau-Hsuan Li, An-Ni Lin, Wei-Che Lin

Published in: European Radiology | Issue 3/2019

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Abstract

Objectives

The aim of this study was to evaluate the relationship between cognitive impairment and brain perfusion using arterial spin labelling (ASL) in end-stage renal disease (ESRD) patients undergoing PD.

Methods

ESRD patients undergoing PD were recruited. Laboratory screening, neuropsychological tests and ASL magnetic resonance imaging (MRI) were conducted prior to and after 6 months of PD. Age- and sex-matched normal subjects without ESRD served as the control group. Comparisons of regional CBF between ESRD patients before or after undergoing PD and normal controls were performed. Correlations between biochemical, neuropsychological and CBF data were also conducted to evaluate the relationships.

Results

ESRD patients showed poor performance in many of the neuropsychological tests; PD improved cognition in some domains. Pre-PD patients had higher mean CBF than post-PD patients and normal controls, but no significant difference was found between the normal controls and post-PD patients. Negative correlations were observed pre-PD (regional CBF in left hippocampus vs. perseverative responses, r = -0.662, p = 0.014), post-PD (mean CBF vs. haemoglobin level, r = -0.766, p = 0.002), and before and after PD (change in CBF in the left putamen vs. change in haematocrit percentage, r = -0.808, p = 0.001).

Conclusion

Before PD, ESRD patients had increased cerebral perfusion that was related to poorer executive function, especially in the left hippocampus. Post-PD patients performed better in some cognitive test domains than pre-PD patients. The degree of anaemia, i.e., haemoglobin level or haematocrit percentage, might predict cognitive impairment in PD patients.

Key Points

• In this study, ESRD patients before PD had cerebral hyperperfusion that was related to poorer executive function.
• Post-PD patients performed better in some cognitive test domains than pre-PD patients did.
• The degree of anaemia might predict cognitive impairment in PD patients.
Appendix
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Metadata
Title
Decreased cerebral blood flow and improved cognitive function in patients with end-stage renal disease after peritoneal dialysis: An arterial spin-labelling study
Authors
Ben-Chung Cheng
Po-Cheng Chen
Pei-Chin Chen
Cheng-Hsien Lu
Yu-Chi Huang
Kun-Hsien Chou
Shau-Hsuan Li
An-Ni Lin
Wei-Che Lin
Publication date
01-03-2019
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 3/2019
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-018-5675-9

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