Regional cerebral blood flow in children and young adults with chronic kidney disease

H.-S. Liu, E.A. Hartung, A.F. Jawad, J.B. Ware, N. Laney, A.M. Port, R.C. Gur, S.R. Hooper, J. Radcliffe, S.L. Furth, J.A. Detre

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods: In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years 6 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years 6 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries. Clinical data were also collected. Group-level global and regional CBF differences between patients with CKD and control subjects were assessed. Regression analyses were conducted to evaluate the associations among regional CBF, clinical variables, and cognitive performance. Results: Patients with CKD showed higher global CBF compared with control subjects that was attributable to reduced hematocrit level (mean, 60.2 mL/100 g/min 6 9.0 vs 56.5 mL/100 g/min 6 8.0, respectively). White matter CBF showed correlation with blood pressure (r = 0.244, P = .039), a finding suggestive of altered cerebrovascular autoregulation. Regional CBF differences between patients and control subjects included regions in the “default mode” network. In patients with CKD, positive extrema in the precuneus showed a strong correlation with executive function (r = 0.608, P = .001). Conclusion: Systemic effects of estimated glomerular filtration rate, hematocrit level, and blood pressure on CBF and alterations in regional CBF may reflect impaired brain function underlying neurocognitive symptoms in CKD. These findings further characterize the nature of alterations in brain physiologic features in children, adolescents, and young adults with CKD. © RSNA, 2018
Original languageEnglish
Pages (from-to)849-858
Number of pages10
JournalRadiology
Volume288
Issue number3
DOIs
Publication statusPublished - 2018

Fingerprint

Cerebrovascular Circulation
Regional Blood Flow
Chronic Renal Insufficiency
Young Adult
Hematocrit
Brain
Blood Pressure
Parietal Lobe
Executive Function
Glomerular Filtration Rate
Homeostasis

Keywords

  • adolescent
  • adult
  • arterial spin labeling
  • Article
  • autoregulation
  • blood pressure
  • brain blood flow
  • brain region
  • child
  • chronic kidney failure
  • cognition
  • controlled study
  • cross-sectional study
  • default mode network
  • estimated glomerular filtration rate
  • executive function
  • female
  • hematocrit
  • human
  • major clinical study
  • male
  • neuroimaging
  • precuneus
  • priority journal
  • prospective study
  • white matter
  • brain
  • brain circulation
  • diagnostic imaging
  • nuclear magnetic resonance imaging
  • pathophysiology
  • physiology
  • procedures
  • young adult
  • spin label
  • Adolescent
  • Adult
  • Brain
  • Cerebrovascular Circulation
  • Child
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Prospective Studies
  • Renal Insufficiency, Chronic
  • Spin Labels
  • Young Adult

Cite this

Liu, H-S., Hartung, E. A., Jawad, A. F., Ware, J. B., Laney, N., Port, A. M., ... Detre, J. A. (2018). Regional cerebral blood flow in children and young adults with chronic kidney disease. Radiology, 288(3), 849-858. https://doi.org/10.1148/radiol.2018171339

Regional cerebral blood flow in children and young adults with chronic kidney disease. / Liu, H.-S.; Hartung, E.A.; Jawad, A.F.; Ware, J.B.; Laney, N.; Port, A.M.; Gur, R.C.; Hooper, S.R.; Radcliffe, J.; Furth, S.L.; Detre, J.A.

In: Radiology, Vol. 288, No. 3, 2018, p. 849-858.

Research output: Contribution to journalArticle

Liu, H-S, Hartung, EA, Jawad, AF, Ware, JB, Laney, N, Port, AM, Gur, RC, Hooper, SR, Radcliffe, J, Furth, SL & Detre, JA 2018, 'Regional cerebral blood flow in children and young adults with chronic kidney disease', Radiology, vol. 288, no. 3, pp. 849-858. https://doi.org/10.1148/radiol.2018171339
Liu, H.-S. ; Hartung, E.A. ; Jawad, A.F. ; Ware, J.B. ; Laney, N. ; Port, A.M. ; Gur, R.C. ; Hooper, S.R. ; Radcliffe, J. ; Furth, S.L. ; Detre, J.A. / Regional cerebral blood flow in children and young adults with chronic kidney disease. In: Radiology. 2018 ; Vol. 288, No. 3. pp. 849-858.
@article{480900e8e49946b08707fe97aa53974e,
title = "Regional cerebral blood flow in children and young adults with chronic kidney disease",
abstract = "Purpose: To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods: In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years 6 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years 6 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries. Clinical data were also collected. Group-level global and regional CBF differences between patients with CKD and control subjects were assessed. Regression analyses were conducted to evaluate the associations among regional CBF, clinical variables, and cognitive performance. Results: Patients with CKD showed higher global CBF compared with control subjects that was attributable to reduced hematocrit level (mean, 60.2 mL/100 g/min 6 9.0 vs 56.5 mL/100 g/min 6 8.0, respectively). White matter CBF showed correlation with blood pressure (r = 0.244, P = .039), a finding suggestive of altered cerebrovascular autoregulation. Regional CBF differences between patients and control subjects included regions in the “default mode” network. In patients with CKD, positive extrema in the precuneus showed a strong correlation with executive function (r = 0.608, P = .001). Conclusion: Systemic effects of estimated glomerular filtration rate, hematocrit level, and blood pressure on CBF and alterations in regional CBF may reflect impaired brain function underlying neurocognitive symptoms in CKD. These findings further characterize the nature of alterations in brain physiologic features in children, adolescents, and young adults with CKD. {\circledC} RSNA, 2018",
keywords = "adolescent, adult, arterial spin labeling, Article, autoregulation, blood pressure, brain blood flow, brain region, child, chronic kidney failure, cognition, controlled study, cross-sectional study, default mode network, estimated glomerular filtration rate, executive function, female, hematocrit, human, major clinical study, male, neuroimaging, precuneus, priority journal, prospective study, white matter, brain, brain circulation, diagnostic imaging, nuclear magnetic resonance imaging, pathophysiology, physiology, procedures, young adult, spin label, Adolescent, Adult, Brain, Cerebrovascular Circulation, Child, Female, Humans, Magnetic Resonance Imaging, Male, Prospective Studies, Renal Insufficiency, Chronic, Spin Labels, Young Adult",
author = "H.-S. Liu and E.A. Hartung and A.F. Jawad and J.B. Ware and N. Laney and A.M. Port and R.C. Gur and S.R. Hooper and J. Radcliffe and S.L. Furth and J.A. Detre",
note = "Export Date: 25 October 2018 CODEN: RADLA Correspondence Address: Detre, J.A.; Departments of Neurology and Radiology, Perelman School of Medicine, University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, United States; email: detre@mail.med.upenn.edu Chemicals/CAS: Spin Labels Tradenames: Verio, Siemens, Germany Manufacturers: Siemens, Germany Funding details: UL1RR024134, NIH, National Institutes of Health Funding details: EB015893, NIH, National Institutes of Health Funding details: UL1TR000003, NIH, National Institutes of Health Funding details: MH080729, NIH, National Institutes of Health Funding details: 105TMU-TMUH-05, TMUH, Taipei Medical University Hospital Funding details: 106TMU-TMUH-21, TMUH, Taipei Medical University Hospital Funding details: DH, Department of Health Funding details: NCRR, National Center for Research Resources Funding details: TMU103-AE1-B29, TMU, Taipei Medical University Funding details: MOST106-2221-E-038-004-MY2, MOST, Ministry of Science and Technology, Taiwan Funding details: MOST105-2218-E-038-003-MY2, MOST, Ministry of Science and Technology, Taiwan Funding details: NCATS, National Center for Advancing Translational Sciences Funding details: SAP 4100054843, PDH, Pennsylvania Department of Health Funding text: Study supported in part by a Commonwealth Universal Research Enhancement grant with the Pennsylvania Department of Health (SAP 4100054843). The Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions. The Clinical and Translational Research Center at the Children’s Hospital of Philadelphia is supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (grants UL1RR024134, UL1TR000003). Supported by the National Institutes of Health (grants EB015893, MH080729). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. H.S.L. supported by Taipei Medical University (grant TMU103-AE1-B29), Taipei Medical University Hospital (grants 105TMU-TMUH-05, 106TMU-TMUH-21), and the Ministry of Science and Technology in Taiwan (grants MOST105-2218-E-038-003-MY2, MOST106-2221-E-038-004-MY2). Funding text: Disclosures of Conflicts of Interest: H.S.L. disclosed no relevant relationships. E.A.H. disclosed no relevant relationships. A.F.J. disclosed no relevant relationships. J.B.W. disclosed no relevant relationships. N.L. disclosed no relevant relationships. A.M.P. disclosed no relevant relationships. R.C.G. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: received money for expert testimony; receives royalties from the Brain Resource Centre. Other relationships: institution has a patent issued to Joggle Research; institution has a patent licensed to MindPrint Learning; receives royalties from Brain Resource Center. S.R.H. disclosed no relevant relationships. J.R. disclosed no relevant relationships. S.L.F. disclosed no relevant relationships. J.A.D. disclosed no relevant relationships. References: Moodalbail, D.G., Reiser, K.A., Detre, J.A., Systematic review of structural and functional neuroimaging findings in children and adults with CKD (2013) Clin J Am Soc Nephrol, 8 (8), pp. 1429-1448; Hooper, S.R., Gerson, A.C., Butler, R.W., Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease (2011) Clin J Am Soc Nephrol, 6 (8), pp. 1824-1830; Seidel, U.K., Gronewold, J., Volsek, M., The prevalence, severity, and association with HbA1c and fibrinogen of cognitive impairment in chronic kidney disease (2014) Kidney Int, 85 (3), pp. 693-702; Koren-Morag, N., Goldbourt, U., Tanne, D., Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease (2006) Neurology, 67 (2), pp. 224-228; Yahalom, G., Schwartz, R., Schwammenthal, Y., Chronic kidney disease and clinical outcome in patients with acute stroke (2009) Stroke, 40 (4), pp. 1296-1303; Drew, D.A., Weiner, D.E., Cognitive impairment in chronic kidney disease: Keep vascular disease in mind (2014) Kidney Int, 85 (3), pp. 505-507; Hartung, E.A., Matheson, M., Lande, M.B., Neurocognition in children with auto-somal recessive polycystic kidney disease in the CKiD cohort study (2014) Pediatr Nephrol, 29 (10), pp. 1957-1965; Reivich, M., Blood flow metabolism couple in brain (1974) Res Publ Assoc Res Nerv Ment Dis, 53, pp. 125-140; Sokoloff, L., Relationships among local functional activity, energy metabolism, and blood flow in the central nervous system (1981) Fed Proc, 40 (8), pp. 2311-2316; Gur, R.C., Ragland, J.D., Reivich, M., Greenberg, J.H., Alavi, A., Gur, R.E., Regional differences in the coupling between resting cerebral blood flow and metabolism may indicate action preparedness as a default state (2009) Cereb Cortex, 19 (2), pp. 375-382; Hartung, E.A., Laney, N., Kim, J.Y., Design and methods of the NiCK study: Neurocognitive assessment and magnetic resonance imaging analysis of children and young adults with chronic kidney disease (2015) BMC Nephrol, 16, p. 66; Gottesman, R.F., Sojkova, J., Beason-Held, L.L., Patterns of regional cerebral blood flow associated with low hemoglobin in the Baltimore Longitudinal Study of Aging (2012) J Gerontol A Biol Sci Med Sci, 67 (9), pp. 963-969; Harris, P.A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., Conde, J.G., Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support (2009) J Biomed Inform, 42 (2), pp. 377-381; Gur, R.C., Richard, J., Hughett, P., A cognitive neuroscience-based computerized battery for efficient measurement of individual differences: Standardization and initial construct validation (2010) J Neurosci Methods, 187 (2), pp. 254-262; Gur, R.C., Richard, J., Calkins, M.E., Age group and sex differences in performance on a computerized neurocognitive battery in children age 8-21 (2012) Neuropsychology, 26 (2), pp. 251-265; Ruebner, R.L., Laney, N., Kim, J.Y., Neurocognitive dysfunction in children, adolescents, and young adults with CKD (2016) Am J Kidney Dis, 67 (4), pp. 567-575; Hartung, E.A., Kim, J.Y., Laney, N., Evaluation of neurocognition in youth with CKD using a novel computerized neurocognitive battery (2016) Clin J Am Soc Nephrol, 11 (1), pp. 39-46; Wu, W.C., Fern{\'a}ndez-Seara, M., Detre, J.A., Wehrli, F.W., Wang, J., A theoretical and experimental investigation of the tagging efficiency of pseudocontinuous arterial spin labeling (2007) Magn Reson Med, 58 (5), pp. 1020-1027; Wang, Z., Aguirre, G.K., Rao, H., Empirical optimization of ASL data analysis using an ASL data processing toolbox: ASLtbx (2008) Magn Reson Imaging, 26 (2), pp. 261-269; Lu, H., Clingman, C., Golay, X., Van Zijl, P.C., Determining the longitudinal relaxation time (T1) of blood at 3.0 Tesla (2004) Magn Reson Med, 52 (3), pp. 679-682; Gipson, D.S., Duquette, P.J., Icard, P.F., Hooper, S.R., The central nervous system in childhood chronic kidney disease (2007) Pediatr Nephrol, 22 (10), pp. 1703-1710; Mayer, A.R., Bedrick, E.J., Ling, J.M., Toulouse, T., Dodd, A., Methods for identifying subject-specific abnormalities in neuroimaging data (2014) Hum Brain Mapp, 35 (11), pp. 5457-5470; Tamura, M.K., Pajewski, N.M., Bryan, R.N., Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults (2016) Neurology, 86 (13), pp. 1208-1216; 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Al-Ahmad, A., Rand, W.M., Manjunath, G., Reduced kidney function and anemia as risk factors for mortality in patients with left ventricular dysfunction (2001) J Am Coll Cardiol, 38 (4), pp. 955-962; Hsu, C.Y., Bates, D.W., Kuperman, G.J., Curhan, G.C., Relationship between hematocrit and renal function in men and women (2001) Kidney Int, 59 (2), pp. 725-731; Salas, P., Pinto, V., Rodriguez, J., Zambrano, M.J., Mericq, V., Growth retardation in children with kidney disease (2013) Int J Endocrinol, 2013, p. 970946; Sedaghat, S., Vernooij, M.W., Loehrer, E., Kidney function and cerebral blood flow: The Rotterdam Study (2016) J Am Soc Nephrol, 27 (3), pp. 715-721; Aries, M.J., Elting, J.W., De Keyser, J., Kremer, B.P., Vroomen, P.C., Cerebral autoregulation in stroke: A review of transcranial Doppler studies (2010) Stroke, 41 (11), pp. 2697-2704; Ruland, S., Aiyagari, V., Cerebral autoregulation and blood pressure lowering (2007) Hypertension, 49 (5), pp. 977-978; Ono, M., Joshi, B., Brady, K., Risks for impaired cerebral autoregulation during cardiopulmonary bypass and postoperative stroke (2012) Br J Anaesth, 109 (3), pp. 391-398; 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Utevsky, A.V., Smith, D.V., Huettel, S.A., Precuneus is a functional core of the default-mode network (2014) J Neurosci, 34 (3), pp. 932-940; Vasconcelos, L.G., Jackowski, A.P., Oliveira, M.O., The thickness of posterior cortical areas is related to executive dysfunction in Alzheimer's disease (2014) Clinics (S{\~a}o Paulo), 69 (1), pp. 28-37; Jiang, X.L., Wen, J.Q., Zhang, L.J., Cerebral blood flow changes in hemodialysis and peritoneal dialysis patients: An arterial-spin labeling MR imaging (2016) Metab Brain Dis, 31 (4), pp. 929-936; Ye, F.Q., Frank, J.A., Weinberger, D.R., McLaughlin, A.C., Noise reduction in 3D perfusion imaging by attenuating the static signal in arterial spin tagging (ASSIST) (2000) Magn Reson Med, 44 (1), pp. 92-100; Duyn, J.H., Tan, C.X., Van Gelderen, P., Yongbi, M.N., High-sensitivity single-shot perfusion-weighted fMRI (2001) Magn Reson Med, 46 (1), pp. 88-94; Maleki, N., Dai, W., Alsop, D.C., Optimization of background suppression for arterial spin labeling perfusion imaging (2012) MAGMA, 25 (2), pp. 127-133; 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year = "2018",
doi = "10.1148/radiol.2018171339",
language = "English",
volume = "288",
pages = "849--858",
journal = "Radiology",
issn = "0033-8419",
publisher = "Radiological Society of North America Inc.",
number = "3",

}

TY - JOUR

T1 - Regional cerebral blood flow in children and young adults with chronic kidney disease

AU - Liu, H.-S.

AU - Hartung, E.A.

AU - Jawad, A.F.

AU - Ware, J.B.

AU - Laney, N.

AU - Port, A.M.

AU - Gur, R.C.

AU - Hooper, S.R.

AU - Radcliffe, J.

AU - Furth, S.L.

AU - Detre, J.A.

N1 - Export Date: 25 October 2018 CODEN: RADLA Correspondence Address: Detre, J.A.; Departments of Neurology and Radiology, Perelman School of Medicine, University of Pennsylvania, 3W Gates Pavilion, 3400 Spruce St, United States; email: detre@mail.med.upenn.edu Chemicals/CAS: Spin Labels Tradenames: Verio, Siemens, Germany Manufacturers: Siemens, Germany Funding details: UL1RR024134, NIH, National Institutes of Health Funding details: EB015893, NIH, National Institutes of Health Funding details: UL1TR000003, NIH, National Institutes of Health Funding details: MH080729, NIH, National Institutes of Health Funding details: 105TMU-TMUH-05, TMUH, Taipei Medical University Hospital Funding details: 106TMU-TMUH-21, TMUH, Taipei Medical University Hospital Funding details: DH, Department of Health Funding details: NCRR, National Center for Research Resources Funding details: TMU103-AE1-B29, TMU, Taipei Medical University Funding details: MOST106-2221-E-038-004-MY2, MOST, Ministry of Science and Technology, Taiwan Funding details: MOST105-2218-E-038-003-MY2, MOST, Ministry of Science and Technology, Taiwan Funding details: NCATS, National Center for Advancing Translational Sciences Funding details: SAP 4100054843, PDH, Pennsylvania Department of Health Funding text: Study supported in part by a Commonwealth Universal Research Enhancement grant with the Pennsylvania Department of Health (SAP 4100054843). The Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions. The Clinical and Translational Research Center at the Children’s Hospital of Philadelphia is supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health (grants UL1RR024134, UL1TR000003). Supported by the National Institutes of Health (grants EB015893, MH080729). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. H.S.L. supported by Taipei Medical University (grant TMU103-AE1-B29), Taipei Medical University Hospital (grants 105TMU-TMUH-05, 106TMU-TMUH-21), and the Ministry of Science and Technology in Taiwan (grants MOST105-2218-E-038-003-MY2, MOST106-2221-E-038-004-MY2). Funding text: Disclosures of Conflicts of Interest: H.S.L. disclosed no relevant relationships. E.A.H. disclosed no relevant relationships. A.F.J. disclosed no relevant relationships. J.B.W. disclosed no relevant relationships. N.L. disclosed no relevant relationships. A.M.P. disclosed no relevant relationships. R.C.G. Activities related to the present article: disclosed no relevant relationships. Activities not related to the present article: received money for expert testimony; receives royalties from the Brain Resource Centre. Other relationships: institution has a patent issued to Joggle Research; institution has a patent licensed to MindPrint Learning; receives royalties from Brain Resource Center. S.R.H. disclosed no relevant relationships. J.R. disclosed no relevant relationships. S.L.F. disclosed no relevant relationships. J.A.D. disclosed no relevant relationships. References: Moodalbail, D.G., Reiser, K.A., Detre, J.A., Systematic review of structural and functional neuroimaging findings in children and adults with CKD (2013) Clin J Am Soc Nephrol, 8 (8), pp. 1429-1448; Hooper, S.R., Gerson, A.C., Butler, R.W., Neurocognitive functioning of children and adolescents with mild-to-moderate chronic kidney disease (2011) Clin J Am Soc Nephrol, 6 (8), pp. 1824-1830; Seidel, U.K., Gronewold, J., Volsek, M., The prevalence, severity, and association with HbA1c and fibrinogen of cognitive impairment in chronic kidney disease (2014) Kidney Int, 85 (3), pp. 693-702; Koren-Morag, N., Goldbourt, U., Tanne, D., Renal dysfunction and risk of ischemic stroke or TIA in patients with cardiovascular disease (2006) Neurology, 67 (2), pp. 224-228; Yahalom, G., Schwartz, R., Schwammenthal, Y., Chronic kidney disease and clinical outcome in patients with acute stroke (2009) Stroke, 40 (4), pp. 1296-1303; Drew, D.A., Weiner, D.E., Cognitive impairment in chronic kidney disease: Keep vascular disease in mind (2014) Kidney Int, 85 (3), pp. 505-507; Hartung, E.A., Matheson, M., Lande, M.B., Neurocognition in children with auto-somal recessive polycystic kidney disease in the CKiD cohort study (2014) Pediatr Nephrol, 29 (10), pp. 1957-1965; Reivich, M., Blood flow metabolism couple in brain (1974) Res Publ Assoc Res Nerv Ment Dis, 53, pp. 125-140; Sokoloff, L., Relationships among local functional activity, energy metabolism, and blood flow in the central nervous system (1981) Fed Proc, 40 (8), pp. 2311-2316; Gur, R.C., Ragland, J.D., Reivich, M., Greenberg, J.H., Alavi, A., Gur, R.E., Regional differences in the coupling between resting cerebral blood flow and metabolism may indicate action preparedness as a default state (2009) Cereb Cortex, 19 (2), pp. 375-382; Hartung, E.A., Laney, N., Kim, J.Y., Design and methods of the NiCK study: Neurocognitive assessment and magnetic resonance imaging analysis of children and young adults with chronic kidney disease (2015) BMC Nephrol, 16, p. 66; Gottesman, R.F., Sojkova, J., Beason-Held, L.L., Patterns of regional cerebral blood flow associated with low hemoglobin in the Baltimore Longitudinal Study of Aging (2012) J Gerontol A Biol Sci Med Sci, 67 (9), pp. 963-969; Harris, P.A., Taylor, R., Thielke, R., Payne, J., Gonzalez, N., Conde, J.G., Research electronic data capture (REDCap): A metadata-driven methodology and workflow process for providing translational research informatics support (2009) J Biomed Inform, 42 (2), pp. 377-381; Gur, R.C., Richard, J., Hughett, P., A cognitive neuroscience-based computerized battery for efficient measurement of individual differences: Standardization and initial construct validation (2010) J Neurosci Methods, 187 (2), pp. 254-262; Gur, R.C., Richard, J., Calkins, M.E., Age group and sex differences in performance on a computerized neurocognitive battery in children age 8-21 (2012) Neuropsychology, 26 (2), pp. 251-265; Ruebner, R.L., Laney, N., Kim, J.Y., Neurocognitive dysfunction in children, adolescents, and young adults with CKD (2016) Am J Kidney Dis, 67 (4), pp. 567-575; Hartung, E.A., Kim, J.Y., Laney, N., Evaluation of neurocognition in youth with CKD using a novel computerized neurocognitive battery (2016) Clin J Am Soc Nephrol, 11 (1), pp. 39-46; Wu, W.C., Fernández-Seara, M., Detre, J.A., Wehrli, F.W., Wang, J., A theoretical and experimental investigation of the tagging efficiency of pseudocontinuous arterial spin labeling (2007) Magn Reson Med, 58 (5), pp. 1020-1027; Wang, Z., Aguirre, G.K., Rao, H., Empirical optimization of ASL data analysis using an ASL data processing toolbox: ASLtbx (2008) Magn Reson Imaging, 26 (2), pp. 261-269; Lu, H., Clingman, C., Golay, X., Van Zijl, P.C., Determining the longitudinal relaxation time (T1) of blood at 3.0 Tesla (2004) Magn Reson Med, 52 (3), pp. 679-682; Gipson, D.S., Duquette, P.J., Icard, P.F., Hooper, S.R., The central nervous system in childhood chronic kidney disease (2007) Pediatr Nephrol, 22 (10), pp. 1703-1710; Mayer, A.R., Bedrick, E.J., Ling, J.M., Toulouse, T., Dodd, A., Methods for identifying subject-specific abnormalities in neuroimaging data (2014) Hum Brain Mapp, 35 (11), pp. 5457-5470; Tamura, M.K., Pajewski, N.M., Bryan, R.N., Chronic kidney disease, cerebral blood flow, and white matter volume in hypertensive adults (2016) Neurology, 86 (13), pp. 1208-1216; 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PY - 2018

Y1 - 2018

N2 - Purpose: To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods: In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years 6 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years 6 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries. Clinical data were also collected. Group-level global and regional CBF differences between patients with CKD and control subjects were assessed. Regression analyses were conducted to evaluate the associations among regional CBF, clinical variables, and cognitive performance. Results: Patients with CKD showed higher global CBF compared with control subjects that was attributable to reduced hematocrit level (mean, 60.2 mL/100 g/min 6 9.0 vs 56.5 mL/100 g/min 6 8.0, respectively). White matter CBF showed correlation with blood pressure (r = 0.244, P = .039), a finding suggestive of altered cerebrovascular autoregulation. Regional CBF differences between patients and control subjects included regions in the “default mode” network. In patients with CKD, positive extrema in the precuneus showed a strong correlation with executive function (r = 0.608, P = .001). Conclusion: Systemic effects of estimated glomerular filtration rate, hematocrit level, and blood pressure on CBF and alterations in regional CBF may reflect impaired brain function underlying neurocognitive symptoms in CKD. These findings further characterize the nature of alterations in brain physiologic features in children, adolescents, and young adults with CKD. © RSNA, 2018

AB - Purpose: To investigate the pathophysiologic effects of chronic kidney disease (CKD) on brain function in children with CKD by correlating cerebral blood flow (CBF) with clinical and behavioral indexes. Materials and Methods: In this prospective study, 73 pediatric patients with CKD (mean age, 15.80 years 6 3.63; range, 9-25 years) and 57 control subjects (mean age, 15.65 years 6 3.76; range, 9-25 years) were recruited. CBF measurements were acquired with an MRI arterial spin labeling scheme. Neurocognitive measurements were performed with traditional and computerized neurocognitive batteries. Clinical data were also collected. Group-level global and regional CBF differences between patients with CKD and control subjects were assessed. Regression analyses were conducted to evaluate the associations among regional CBF, clinical variables, and cognitive performance. Results: Patients with CKD showed higher global CBF compared with control subjects that was attributable to reduced hematocrit level (mean, 60.2 mL/100 g/min 6 9.0 vs 56.5 mL/100 g/min 6 8.0, respectively). White matter CBF showed correlation with blood pressure (r = 0.244, P = .039), a finding suggestive of altered cerebrovascular autoregulation. Regional CBF differences between patients and control subjects included regions in the “default mode” network. In patients with CKD, positive extrema in the precuneus showed a strong correlation with executive function (r = 0.608, P = .001). Conclusion: Systemic effects of estimated glomerular filtration rate, hematocrit level, and blood pressure on CBF and alterations in regional CBF may reflect impaired brain function underlying neurocognitive symptoms in CKD. These findings further characterize the nature of alterations in brain physiologic features in children, adolescents, and young adults with CKD. © RSNA, 2018

KW - adolescent

KW - adult

KW - arterial spin labeling

KW - Article

KW - autoregulation

KW - blood pressure

KW - brain blood flow

KW - brain region

KW - child

KW - chronic kidney failure

KW - cognition

KW - controlled study

KW - cross-sectional study

KW - default mode network

KW - estimated glomerular filtration rate

KW - executive function

KW - female

KW - hematocrit

KW - human

KW - major clinical study

KW - male

KW - neuroimaging

KW - precuneus

KW - priority journal

KW - prospective study

KW - white matter

KW - brain

KW - brain circulation

KW - diagnostic imaging

KW - nuclear magnetic resonance imaging

KW - pathophysiology

KW - physiology

KW - procedures

KW - young adult

KW - spin label

KW - Adolescent

KW - Adult

KW - Brain

KW - Cerebrovascular Circulation

KW - Child

KW - Female

KW - Humans

KW - Magnetic Resonance Imaging

KW - Male

KW - Prospective Studies

KW - Renal Insufficiency, Chronic

KW - Spin Labels

KW - Young Adult

U2 - 10.1148/radiol.2018171339

DO - 10.1148/radiol.2018171339

M3 - Article

VL - 288

SP - 849

EP - 858

JO - Radiology

JF - Radiology

SN - 0033-8419

IS - 3

ER -