Top

Published in:

01-12-2013 | Research Paper

Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study

Authors: Long Jiang Zhang, Jiqiu Wen, Ling Ni, Jianhui Zhong, Xue Liang, Gang Zheng, Guang Ming Lu

Published in: Metabolic Brain Disease | Issue 4/2013

Abstract

To investigate the pattern of brain volume changes in patients with end-stage renal disease (ESRD) using voxel-based morphometry (VBM) and correlation with clinical and neuropsychological (NP) tests. Fifty seven ESRD patients with no anatomical abnormalities in conventional magnetic resonance imaging [24 patients with abnormal NP scores, 16 male, 39 ± 12 years; 33 patients with normal NP scores, 23 male, 35 ± 9.7 years] and 22 age- and gender-matched healthy controls (14 male, 36 ± 10.1 years) were recruited in this study. Results from VBM analysis were analyzed with ANOVA test among 3 groups (controls, minimal nephro-encephalopathy group, non-nephro-encephalopathy group). Multiple linear regression analysis was used to investigate the effect of serum urea and creatinine, and dialysis duration on the brain volumes in ESRD patients. Correlation analysis was performed to investigate the association between NP scores with the brain volumes in ESRD patients. Compared with healthy controls, ESRD patients showed diffusely decreased gray matter volume that further decreased in the presence of encephalopathy. Multiple linear regression results showed that serum urea was negatively associated with changes in gray matter volume in many regions, while dialysis duration was negatively associated with some white matter volume changes (All P < 0.05, AlphaSim correction). NP scores correlated with some decreased gray matter volume in ESRD patients (All P < 0.05, AlphaSim correction). No correlation was found between white matter volume and any NP test scores in ESRD patients. This study found predominantly decreased gray matter volume in ESRD patients, which was associated with neurocognitive dysfunction. Serum urea level may be a risk factor for decreased gray matter in ESRD patients.

Available only for authorised users

Agildere AM, Kurt A, Yildirim T, Benli S, Altinors N (2001) MRI of neurologic complications in end-stage renal failure patients on hemodialysis: pictorial review. Eur Radiol 11(6):1063–1069PubMedCrossRef

Brouns R, De Deyn PP (2004) Neurological complications in renal failure: a review. Clin Neurol Neurosurg 107(1):1–16PubMedCrossRef

Chiu ML, Li CW, Chang JM, Chiang IC, Ko CH, Chuang HY, Sheu RS, Lee CC, Hsieh TJ (2010) Cerebral metabolic changes in neurologically presymptomatic patients undergoing haemodialysis: in vivo proton MR spectroscopic findings. Eur Radiol 20(6):1502–1507PubMedCrossRef

De Deyn PP, Vanholder R, D’Hooge R (2003) Nitric oxide in uremia: effects of several potentially toxic guanidino compounds. Kidney Int 84(Suppl):S25–S28CrossRef

De Deyn PP, Vanholder R, Eloot S, Glorieux G (2009) Guanidino compounds as uremic (neuro)toxins. Semin Dial 22(4):340–345PubMedCrossRef

Fazekas G, Fazekas F, Schmidt R, Kapeller P, Offenbacher H, Krejs GJ (1995) Brain MRI findings and cognitive impairment in patients undergoing chronic hemodialysis treatment. J Neurol Sci 134(1–2):83–88PubMedCrossRef

Fazekas G, Fazekas F, Schmidt R, Flooh E, Valetitsch H, Kapeller P, Krejs GJ (1996) Pattern of cerebral blood flow and cognition in patients undergoing chronic haemodialysis treatment. Nucl Med Commun 17(7):603–608PubMedCrossRef

Ferenci P, Lockwood A, Mullen K, Tarter R, Weissenborn K, Blei AT (2002) Hepatic encephalopathy– definition, nomenclature, diagnosis, and quantification: final report of the working party at the 11th World Congresses of Gastroenterology, Vienna, 1998. Hepatology 35(3):716–721PubMedCrossRef

Foley RN, Collins AJ (2007) End-stage renal disease in the United States: an update from the United States Renal Data System. J Am Soc Nephrol 18(10):2644–2648PubMedCrossRef

Galons JP, Trouard T, Gmitro AF, Lien YH (1996) Hemodialysis increases apparent diffusion coefficient of brain water in nephrectomized rats measured by isotropic diffusion-weighted magnetic resonance imaging. J Clin Invest 98(3):750–755PubMedCrossRef

Geissler A, Fründ R, Kohler S, Eichhorn HM, Krämer BK, Feuerbach S (1995) Cerebral metabolite patterns in dialysis patients: evaluation with H-1 MR spectroscopy. Radiology 194(3):693–697PubMed

Giang LM, Weiner DE, Agganis BT, Scott T, Sorensen EP, Tighiouart H, Sarnak MJ (2011) Cognitive function and dialysis adequacy: no clear relationship. Am J Nephrol 33(1):33–38PubMedCrossRef

Gotch FA, Sargent JA (1985) A mechanistic analysis of the National Cooperative Dialysis Study (NCDS). Kidney Int 2(3):526–534CrossRef

Hsieh TJ, Chang JM, Chuang HY, Ko CH, Hsieh ML, Liu GC, Hsu JS (2009) End-stage renal disease: in vivo diffusion-tensor imaging of silent white matter damage. Radiology 252(2):518–525PubMedCrossRef

Kamata T, Hishida A, Takita T, Sawada K, Ikegaya N, Maruyama Y, Miyajima H, Kaneko E (2000) Morphologic abnormalities in the brain of chronically hemodialyzed patients without cerebrovascular disease. Am J Nephrol 20(1):27–31PubMedCrossRef

Kim HS, Park JW, Bai DS, Jeong JY, Hong JH, Son SM, Jang SH (2011) Diffusion tensor imaging findings in neurologically asymptomatic patients with end stage renal disease. NeuroRehabilitation 29(1):111–116PubMed

Koushik NS, McArthur SF, Baird AD (2010) Adult chronic kidney disease: neurocognition in chronic renal failure. Neuropsychol Rev 20(1):33–51PubMedCrossRef

Liu JY, Ding J, Lin D, He YF, Dai Z, Chen CZ, Cheng WZ, Wang H, Zhou J, Wang X (2013) T2* MRI of minimal hepatic encephalopathy and cognitive correlates in vivo. J Magn Reson Imaging 37(1):179–186PubMedCrossRef

Madero M, Gul A, Sarnak MJ (2008) Cognitive function in chronic kidney disease. Semin Dial 21(1):29–37PubMedCrossRef

Ni L, Qi R, Zhang LJ, Zhong J, Zheng G, Zhang Z, Zhong Y, Xu Q, Liao W, Jiao Q, Wu X, Fan X, Lu GM (2012) Altered regional homogeneity in the development of minimal hepatic encephalopathy: a resting-state functional MRI study. PLoS One 7(7):e42016PubMedCrossRef

Owen WF Jr, Lew NL, Liu Y, Lowrie EG, Lazarus JM (1993) The urea reduction ratio and serum albumin concentration as predictors of mortality in patients undergoing hemodialysis. N Engl J Med 329(14):1001–1006PubMedCrossRef

Pliskin NH, Yurk HM, Ho LT, Umans JG (1996) Neurocognitive function in chronic hemodialysis patients. Kidney Int 49(5):1435–1440PubMedCrossRef

Prohovnik I, Post J, Uribarri J, Lee H, Sandu O, Langhoff E (2007) Cerebrovascular effects of hemodialysis in chronic kidney disease. J Cereb Blood Flow Metab 27(11):1861–1869PubMedCrossRef

Radić J, Ljutić D, Radić M, Kovaĉić V, Sain M, Curković KD (2010) The possible impact of dialysis modality on cognitive function in chronic dialysis patients. Neth J Med 68(4):153–157PubMed

Savazzi GM, Cusmano F, Musini S (2001) Cerebral imaging changes in patients with chronic renal failure treated conservatively or in hemodialysis. Nephron 89(1):31–36PubMedCrossRef

Shima H, Ishimura E, Naganuma T, Yamazaki T, Kobayashi I, Shidara K, Mori K, Takemoto Y, Shoji T, Inaba M, Okamura M, Nakatani T, Nishizawa Y (2010) Cerebral microbleeds in predialysis patients with chronic kidney disease. Nephrol Dial Transplant 25(5):1554–1559PubMedCrossRef

Tryc AB, Alwan G, Bokemeyer M, Goldbecker A, Hecker H, Haubitz M, Weissenborn K (2011) Cerebral metabolic alterations and cognitive dysfunction in chronic kidney disease. Nephrol Dial Transplant 26(8):2635–2641PubMedCrossRef

Yokoyama S, Hirano H, Uomizu K, Kajiya Y, Tajitsu K, Kusumoto K (2005) High incidence of microbleeds in hemodialysis patients detected by T2*-weighted gradient-echo magnetic resonance imaging. Neurol Med Chir (Tokyo) 45(11):556–560CrossRef

Zhang LJ, Qi R, Zhong J, Xu Q, Zheng G, Lu GM (2012a) The effect of hepatic encephalopathy, hepatic failure, and portosystemic shunt on brain volume of cirrhotic patients: a voxel-based morphometry study. PLoS One 7(8):e42824PubMedCrossRef

Zhang LJ, Zheng G, Zhang L, Zhong J, Wu S, Qi R, Li Q, Wang L, Lu G (2012b) Altered brain functional connectivity in patients with cirrhosis and minimal hepatic encephalopathy: a functional MR imaging study. Radiology 265(2):528–536PubMedCrossRef

Title: Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study
Authors: Long Jiang Zhang
Jiqiu Wen
Ling Ni
Jianhui Zhong
Xue Liang
Gang Zheng
Guang Ming Lu
Publication date: 01-12-2013
Publisher: Springer US
Published in: Metabolic Brain Disease / Issue 4/2013
Print ISSN: 0885-7490
Electronic ISSN: 1573-7365
DOI: https://doi.org/10.1007/s11011-013-9438-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2013

Association of serum bilirubin and uric acid levels changes during neuroinflammation in patients with initial and relapsed demyelination attacks

Expression of autophagy and UPR genes in the developing brain during ethanol-sensitive and resistant periods

Exogenous and endogenous therapeutic effects of combination Sodium Ferulate and bone marrow stromal cells (BMSCs) treatment enhance neurogenesis after rat focal cerebral ischemia

Association between the characteristics of metabolic syndrome and Alzheimer’s disease

The preventive effect of NR2B and NR2D-containing NMDAR antagonists on Aβ-induced LTP disruption in the dentate gyrus of rats

Stressed cybrids model demyelinated axons in multiple sclerosis