title: Cognitive impairment and hippocampal atrophy in chronic kidney disease.
abstract: BACKGROUND
  Cognition impairment is well known in patients with chronic kidney disease (CKD). The relationship between brain structure and cognitive performance in CKD patients is still under investigation. The study aimed to quantitatively assess the relationship between brain structure and cognitive performance in patients with CKD.
  
  
  METHODS
  We recruited 39 patients with CKD and 39 age- and sex-matched control participants from a tertiary medical center. All participants underwent 3-T MRI scan neuropsychological assessments, and renal function tests. FreeSurfer software was used for imaging processing and analysis, including measurement of cortical thickness and gray matter (GM) and white matter volumes.
  
  
  RESULTS
  Compared with control subjects (73.1±7.5 years old), patients with CKD (76.4±8.4 years old) had significantly lower scores on the Mini-Mental State Examination, and forward digit span test (P<.01). Patients with CKD had smaller cerebral GM volume, hippocampus, and decreased cortical thickness (P<.01) relative to the control group. Estimated glomerular filtration rate (eGFR) was correlated with cognitive performance, cortical thickness, GM volume, and hippocampal volume (P<.001). Linear regression analysis revealed that eGFR and GM volume were independently negatively associated with cognitive performance (P<.001), while eGFR and age were negatively associated with cortical thinning and GM volume after controlling for confounding factors.
  
  
  CONCLUSIONS
  This study demonstrated that impaired kidney function is associated not only with poor cognitive performance, but also with small cerebral GM volume and reduced cortical thickness.
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.|Department of Neurology, Min-Sheng General Hospital, Taoyuan, Taiwan.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Chang
authors.affiliation: Division of Nephrology, Department of Medicine, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
authors.forename: C-C
authors.initials: CC
authors.lastname: Lin
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.|Department of Psychiatry, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: C-F
authors.initials: CF
authors.lastname: Tsai
authors.affiliation: Division of Nephrology, Department of Medicine, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.|Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
authors.forename: W-C
authors.initials: WC
authors.lastname: Yang
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.|Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Wang
authors.affiliation: Institute of Biomedical Engineering, National Taiwan University, Taipei, Taiwan.
authors.forename: F-H
authors.initials: FH
authors.lastname: Lin
authors.affiliation: Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.|Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: J-L
authors.identifier: http://orcid.org/0000-0001-9135-3351
authors.initials: JL
authors.lastname: Fuh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D005919:Glomerular Filtration Rate; D066128:Gray Matter / Q000000981:diagnostic imaging; D006624:Hippocampus / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D066127:White Matter / Q000000981:diagnostic imaging
keywords: Hippocampus; cardiovascular disease; chronic kidney disease; cognition; cortical thickness; gray matter volume; magnetic resonance imaging