News | Neuro Imaging | June 25, 2018

Children with Kidney Disease Show Blood Flow Changes in Brain

Arterial spin labeling MRI provides valuable tool in characterizing cerebrovascular function in chronic kidney disease

Children with Kidney Disease Show Blood Flow Changes in Brain

June 25, 2018 — Blood flow changes in the brains of children, adolescents and young adults with chronic kidney disease may explain why many face a higher risk of cognitive impairment, according to a study published online in the journal Radiology.

Prior research has linked chronic kidney disease — a condition characterized by the loss of kidney function over time — with lesions in the brain’s signal-carrying white matter and deficits in cognitive performance. While chronic kidney disease in adults is frequently associated with age-related disorders such as hypertension and diabetes, the disease in childhood often occurs congenitally, yet still affects brain development and cognitive function.

“It’s not clear if the brain problems from kidney disease seen in adults are secondary to the hypertension produced by the disease,” said coauthor John A. Detre, M.D., professor of neurology and radiology, director of the Center for Functional Neuroimaging in Radiology and vice chair for research in neurology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. “In our study, we wanted to look at patients with early kidney disease, before they’ve experienced decades of high blood pressure. In doing this, we could separate the kidney disease effects from those of chronic high blood pressure.”

Detre and colleagues assessed blood flow in the brains of 73 pediatric kidney disease patients, average age just under 16 years, and 57 similarly aged control participants. The researchers used arterial spin labeling, a magnetic resonance imaging (MRI) technique that can noninvasively quantify blood flow in the brain.

Patients with kidney disease showed higher cerebral blood flow compared with controls in certain brain regions — a surprising finding, considering that decreased cognitive performance is generally associated with decreased blood flow in the brain, such as in aging and dementia. There are a couple of possible reasons for this unusual phenomenon, Detre said.

“It may indicate compensatory hyperactivity, in which the brain regions are working extra hard to maintain performance,” he said. “Another possibility is that there’s a disturbance in the regulation of blood flow in these patients.”

White matter cerebral blood flow and blood pressure were also correlated, suggesting that kidney disease patients have problems with cerebrovascular autoregulation, the process that controls blood pressure in the brain. This type of dysfunction could potentially lead to white matter injury, according to Detre.

“Chronic kidney disease appears to affect brain physiology and function even early in the disease,” he said. “This study gives us clues about what changes in brain physiology might underlie cognitive changes.”

Among those changes were differences in blood flow between patients and controls in areas of the brain that correlated with cognitive problems in the patients. Compared with controls, kidney disease patients had cerebral blood flow differences in the default-mode network, the network of brain regions active when a person is not focused on a particular task. Patients with low executive function, or skills related to planning, organizing and paying attention, had significant differences in cerebral blood flow compared with controls.

The findings point to cerebral blood flow measurements with arterial spin labeling as a potentially valuable tool in characterizing cerebrovascular function in chronic kidney disease. This is an important area of research given the associations between kidney disease and neurological function, and the significantly increased risk for transient ischemic attack and stroke in even mild chronic kidney patients.

“Cerebral blood flow is a critically important physiological parameter that you can measure in just a few minutes with arterial spin labeling,” Detre said. “This technique provides a noninvasive way of quantifying cerebral blood flow that doesn’t require use of contrast agent, which is contraindicated in patients with kidney dysfunction.”

For more information: www.pubs.rsna.org/journal/radiology

Reference

Liu H., Hartung E.A., Jawad A.F., et al. "Regional Cerebral Blood Flow in Children and Young Adults with Chronic Kidney Disease." Radiology, June 12, 2018. https://doi.org/10.1148/radiol.2018171339

Related Content

The cartilage in this MRI scan of a knee is colorized to show greater contrast between shades of gray.

The cartilage in this MRI scan of a knee is colorized to show greater contrast between shades of gray. Image courtesy of Kundu et al. (2020) PNAS

News | Artificial Intelligence | September 22, 2020
September 22, 2020 — Researchers at the University of Pitts...
New research from King's College London has found that COVID-19 may be diagnosed on the same emergency scans intended to diagnose stroke.

Canon Medical Systems

News | Cardiac Imaging | September 22, 2020
September 22, 2020 — New research from King's College London has
According to Philips, MR-STAT is a major shift in MRI, relying on a new, smart acquisition scheme and machine-assisted reconstruction. It delivers multiple quantitative MR parameters in a single fast scan, and represents a significant advance in MR tissue classification, fueling big data algorithms and AI-enabled integrated diagnostic solutions.

Image courtesy of Philips Healthcare

Feature | Magnetic Resonance Imaging (MRI) | September 21, 2020 | By Melinda Taschetta-Millane
A new report,...
Figure 1. Doppler flows in subpleural consolidation shows smoothly dilated branching arteries

Figure 1. Doppler flows in subpleural consolidation shows smoothly dilated branching arteries 

Feature | Radiology Imaging | September 17, 2020 | By Robert Bard, M.D. PC, DABR, FASLM
COVID-19 is routinely studied using...
Ultrasound-guided carpal tunnel release quickly improves hand function and reduces hand discomfort, making the procedure a safe, effective, and less invasive alternative to traditional open or endoscopic surgery

Patients answered three questionnaires (Quick-Disabilities of the Arm, Shoulder, and Hand [QDASH] and two parts of the Boston Carpal Tunnel Syndrome Questionnaire: symptom severity [BCTSQ-SS] and functional status [BCTSQ-FS] scales) assessing the affected wrist's function and discomfort immediately pre-procedure, 2 weeks post-procedure, and at least one year post-procedure. Infographic courtesy of the American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Ultrasound Imaging | September 17, 2020
September 17, 2020 — According to ARRS' American Journal of Roentgenology (AJR),...
HABLE study prioritizes brain imaging and biomarker research among Mexican Americans.

Getty Images

News | PET Imaging | September 14, 2020
September 14, 2020 — To meet the pressing need to better understand the prevalence, progression, and clinical impact
 A cardiac MRI is effective in identifying inflammation of the heart muscle in athletes and can help determine when those who have recovered from COVID-19 can safely return to play in competitive sports, according to a new study by researchers at The Ohio State University Wexner Medical Center.

Getty Images

News | Cardiac Imaging | September 14, 2020
September 14, 2020 — A...
All intensive care unit equipment, including ventilators, pumps, and monitoring devices, as well as the point-of-care magnetic resonance image operator and bedside nurse, remained in the room. All equipment was operational during scanning.

All intensive care unit equipment, including ventilators, pumps, and monitoring devices, as well as the point-of-care magnetic resonance image operator and bedside nurse, remained in the room. All equipment was operational during scanning. Image courtesy of JAMA Neurology

News | Magnetic Resonance Imaging (MRI) | September 11, 2020
September 11, 2020 — A portable, low-field...
Six months after deployment, the no-show rate of the predictive model was 15.9%, compared with 19.3% in the preceding 12-month preintervention period — corresponding to a 17.2% improvement from the baseline no-show rate (p < 0.0001). The no-show rates of contactable and noncontactable patients in the group at high risk of appointment no-shows as predicted by the model were 17.5% and 40.3%, respectively (p < 0.0001).

Weekly outpatient MRI appointment no-show rates for 1 year before (19.3%) and 6 months after (15.9%) implementation of intervention measures in March 2019, as guided by XGBoost prediction model. Squares denote data points. Courtesy of the  American Roentgen Ray Society (ARRS), American Journal of Roentgenology (AJR)

News | Artificial Intelligence | September 10, 2020
September 10, 2020 — According to ARRS’