title: Correlation of hippocampal atrophy with hyperhomocysteinemia in hemodialysis patients: An exploratory pilot study.
abstract: BACKGROUND
  Cognitive impairment is one of the important critical issues in hemodialysis (HD) patients. However, the associating factors of brain atrophy in HD patients have not been fully elucidated.
  
  
  OBJECTIVE
  Brain magnetic resonance imaging (MRI) was performed in 34 of total 72 HD outpatients in our dialysis center. These MRI images were analyzed by an application software; Voxel-based Specific Regional Analysis System for Alzheimer's Disease (VSRAD). VSRAD quantitatively calculates the extent of brain atrophy (percent of volume reduction) comparing with a MRI imaging database of 80 age-matched healthy controls. The extent of both hippocampal and whole-brain atrophy was evaluated with possible contributing factors.
  
  
  RESULTS
  In all patients, the mean extent of hippocampal atrophy was 27.3%, and the mean extent of whole-brain atrophy was 11.2%. The extent of hippocampal atrophy was significantly correlated with low body mass index (BMI), total serum homocysteine (tHcy) levels, and brachial-ankle pulse wave velocity (baPWV). The extent of whole-brain atrophy showed significant correlations with age, hypoalbuminemia, and baPWV. Based on the multiple regression analysis, tHcy was an independent determinant of hippocampal atrophy (β = 0.460, R2 = 0.189, P<0.01); while age was an independent determinant of whole-brain atrophy (β = 0.594, R2 = 0.333, P<0.01).
  
  
  CONCLUSIONS
  In this exploratory pilot study, hippocampal atrophy was significantly correlated with hyperhomocysteinemia in HD patients.
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Maesato
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohtake
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mochida
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Ishioka
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Oka
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Moriya
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Sumi
authors.initials: S
authors.lastname: Hidaka
authors.affiliation: Department of Kidney Disease and Transplant Center, Shonan Kamakura General Hospital Kamakura, Kanagawa, Japan.
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kobayashi
mesh_terms: D000367:Age Factors; D000368:Aged; D055109:Ankle Brachial Index; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D001284:Atrophy / Q000000981:diagnostic imaging*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006624:Hippocampus / Q000000981:diagnostic imaging*; D006710:Homocysteine / Q000097:blood; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications* / Q000000981:diagnostic imaging; D034141:Hypoalbuminemia / Q000150:complications / Q000000981:diagnostic imaging; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D010045:Outpatients; D010865:Pilot Projects; D063177:Pulse Wave Analysis; D012044:Regression Analysis; D006435:Renal Dialysis
chemical_list: D006710:Homocysteine