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ORIGINAL RESEARCH article

Front. Neurol.
Sec. Applied Neuroimaging
Volume 15 - 2024 | doi: 10.3389/fneur.2024.1480536

Effect of glymphatic system function on cognitive function in patients with chronic kidney disease

Provisionally accepted
Junghae Ko Junghae Ko Bong Soo Park Bong Soo Park Chang Min Heo Chang Min Heo Jiyae Yi Jiyae Yi Dong Ah Lee Dong Ah Lee Kang Min Park Kang Min Park *
  • Inje University Haeundae Paik Hospital, Busan, Republic of Korea

The final, formatted version of the article will be published soon.

    Objectives: Studies have recently shown an alteration of the structural connectivity and a dysfunctional glymphatic system in patients with chronic kidney disease (CKD). In this study, we aimed to investigate the effects of the structural connectivity and glymphatic system on the cognitive function of patients with CKD.We prospectively enrolled patients with CKD and healthy controls. The CKD group was divided into two regarding their cognitive function. All patients received brain magnetic resonance imaging, including diffusion tensor imaging (DTI). We calculated the measures of structural connectivity and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index, a neuroimaging marker of the glymphatic system function, and compared the indices between groups.The mean clustering coefficient, local efficiency, and small-worldness index in patients with CKD were lower than those in healthy controls (0.125±0.056 vs. 0.167±0.082, p=0.008; 1.191±0.183 vs. 1.525±0.651, p=0.002; 0.090±0.043 vs. 0.143±0.102, p=0.003; respectively). The DTI-ALPS index was lower in patients with CKD than in healthy controls (1.436 vs. 1.632, p<0.001). Additionally, the DTI-ALPS index differed significantly between CKD patients with and without cognitive impairment. Notably, this index was lower in patients with CKD and cognitive impairment than in patients without cognitive impairment (1.338 vs. 1.494, p=0.031).However, there were no differences of the structural connectivity between CKD patients with and without cognitive impairment.We found lower DTI-ALPS index in patients with CKD, which could be related with glymphatic system dysfunction. Moreover, those with cognitive impairment in the CKD group had a lower index than those without, indicating a link between the glymphatic system function and cognitive function.

    Keywords: Chronic Kidney Disease, Diffusion Tensor Imaging, Glymphatic system, Cognitive fuction, renal failure

    Received: 15 Aug 2024; Accepted: 09 Sep 2024.

    Copyright: © 2024 Ko, Park, Heo, Yi, Lee and Park. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kang Min Park, Inje University Haeundae Paik Hospital, Busan, Republic of Korea

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.