title: Gray matter volume and white matter lesions in chronic kidney disease: exploring the association with depressive symptoms.
abstract: Chronic kidney disease (CKD) is associated with structural brain damage and with a high prevalence of depression. We therefore investigated structural brain alterations in both gray and white matter in CKD patients, focusing on depression-related (frontal-subcortical) regions.
  
  
  
  This cross-sectional MRI study in 24 CKD patients and 24 age- and sex-matched controls first tested whether CKD was associated with regionally lower gray matter (GM) volumes and more severe white matter lesions (WMLs). In exploratory subanalyses, we examined whether differences were more pronounced in CKD patients with depressive symptoms.
  
  
  
  CKD patients showed lower global GM volume (P=.04) and more severe WMLs (P=.04) compared to controls. In addition, we found substantial clusters of lower GM in the bilateral orbitofrontal-cortex for CKD patients, which were however nonsignificant after proper multiple-comparison correction. In exploratory analyses for depressed CKD patients, reduced GM clusters were mainly detected within the frontal lobe. WML severity was unrelated to depression.
  
  
  
  CKD was characterized by differences in brain structure. Although subthreshold, lower GM volumes were observed in depression-related brain areas and were more pronounced for depressed patients. There is a need for replication in larger and longitudinal studies to investigate whether WMLs and regional GM reductions may render CKD patients more susceptible for depression.
authors.affiliation: University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands. Electronic address: m.meurs@umcg.nl.
authors.forename: Maaike
authors.initials: M
authors.lastname: Meurs
authors.affiliation: University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands. Electronic address: a.m.roest@umcg.nl.
authors.forename: Annelieke M
authors.initials: AM
authors.lastname: Roest
authors.affiliation: University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands. Electronic address: n.a.groenewold01@umcg.nl.
authors.forename: Nynke A
authors.initials: NA
authors.lastname: Groenewold
authors.affiliation: University of Groningen/University Medical Center Groningen, Department of Internal Medicine, Division of Nephrology, The Netherlands. Electronic address: c.f.m.franssen@umcg.nl.
authors.forename: Casper F M
authors.initials: CF
authors.lastname: Franssen
authors.affiliation: Dialyses Center Groningen, The Netherlands. Electronic address: r.westerhuis@dcg.nl.
authors.forename: Ralf
authors.initials: R
authors.lastname: Westerhuis
authors.affiliation: Martini Ziekenhuis Groningen, Department of Internal Medicine, The Netherlands. Electronic address: kloppenw@mzh.nl.
authors.forename: Wybe Douwe
authors.initials: WD
authors.lastname: Kloppenburg
authors.affiliation: University Medical Center Groningen, department of Psychiatry, the Netherlands, GGZ Drenthe, Assen, the Netherlands. Electronic address: b.doornbos@umcg.nl.
authors.forename: Bennard
authors.initials: B
authors.lastname: Doornbos
authors.affiliation: University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands. Electronic address: lindy.beukema@gmail.com.
authors.forename: Lindy
authors.initials: L
authors.lastname: Beukema
authors.affiliation: University of Groningen/University Medical Center Groningen, department of Radiology, The Netherlands. Electronic address: h.lindmae@umcg.nl.
authors.forename: Hanna
authors.initials: H
authors.lastname: Lindmäe
authors.affiliation: University of Groningen/University Medical Center Groningen, department of Radiology, The Netherlands. Electronic address: j.c.de.groot@umcg.nl.
authors.forename: Jan Cees
authors.initials: JC
authors.lastname: de Groot
authors.affiliation: University of Groningen/University Medical Center Groningen, Neuroimaging Center, department of Neuroscience, section Cognitive NeuroPsychiatry, The Netherlands. Electronic address: m.j.van.tol@umcg.nl.
authors.forename: Marie-José
authors.initials: MJ
authors.lastname: van Tol
authors.affiliation: University of Groningen/University Medical Center Groningen, Department of psychiatry - Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), The Netherlands. Electronic address: peter.de.jonge@umcg.nl.
authors.forename: Peter
authors.initials: P
authors.lastname: de Jonge
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003863:Depression / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D066127:White Matter / Q000000981:diagnostic imaging / Q000473:pathology*
keywords: Chronic kidney disease (CKD); Depression; Gray matter; MRI; Renal disease; White matter lesion