Cognitive Impairment in Chronic Kidney Disease Is Associated with Glymphatic System Dysfunction

Autor: Shuqin Xu, Jiuqi Wang, Kedi Sun, Lin Meng, Chi Qin, Renyi Feng, Yiming Tian, Yanping Zhai, Dongxiao Liang, Rui Zhang, Haiyan Tian, Han Liu, Yongkang Chen, Yu Fu, Pei Chen, Qingyong Zhu, Junfang Teng, Xuejing Wang
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Kidney Diseases, Pp 1-14 (2023)
Druh dokumentu: article
ISSN: 2296-9381
2296-9357
DOI: 10.1159/000530635
Popis: Introduction: This study was designed to explore the associations between impaired cognition in chronic kidney disease (CKD) patients and the dysfunction of the glymphatic system. Method: Data were obtained from 77 CKD patients and 50 age-matched healthy control individuals from the First Affiliated Hospital of Zhengzhou University. CKD patients were stratified into with and without impaired cognitive function. T2-weighted magnetic resonance imaging results were used to assess area ratios for the perivascular space and ventricles in participants, while the Montreal Cognitive Assessment and the Mini-Mental State Examination were employed to measure cognitive function. Correlations between the perivascular space or ventricle area ratios and cognitive impairment were assessed in CKD patients. Results: Significant increases in the burden of enlarged perivascular spaces in the frontal cortex and basal ganglia were observed in CKD patients with cognitive impairment relative to those without such impairment, with a concomitant increase in analyzed ventricle area ratios. Enlarged perivascular spaces in the frontal cortex, basal ganglia and increased area ratios of lateral ventricles and 4th ventricle exhibited relatively high sensitivity and specificity as means of differing between the CKD patients with and without cognitive impairment. Conclusion: These results indicate that the burden of enlarged perivascular spaces in the frontal cortex and basal ganglia and increases in ventricle area ratio values may offer utility as biomarkers that can aid in detection of even mild cognitive decline in individuals with CKD. The dysfunction of the glymphatic system may play a key role in the pathogenesis of CKD-related cognitive impairment.
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