Functional Magnetic Resonance Imaging Findings in Children and Adolescents With Chronic Kidney Disease: Preliminary Findings

Abstract

This cross-sectional study provides preliminary findings from one of the first functional brain imaging studies in children with chronic kidney disease (CKD). The sample included 21 children with CKD (ages, 14.4 ± 3.0 y) and 11 healthy controls (ages, 14.5 ± 3.4 y). Using functional magnetic resonance imaging during a visual-spatial working memory task, findings showed that the CKD group and healthy controls invoked similar brain regions for encoding and retrieval phases of the task, but significant group differences were noted in the activation patterns for both components of the task. For the encoding phase, the CKD group showed lower activation in the posterior cingulate, anterior cingulate, precuneus, and middle occipital gyrus than the control group, but more activation in the superior temporal gyrus, middle frontal gyrus, middle temporal gyrus, and the insula. For the retrieval phase, the CKD group showed underactivation for brain systems involving the posterior cingulate, medial frontal gyrus, occipital lobe, and middle temporal gyrus, and greater activation than the healthy controls in the postcentral gyrus. Few group differences were noted with respect to disease severity. These preliminary findings support evidence showing a neurologic basis to the cognitive difficulties evident in pediatric CKD, and lay the foundation for future studies to explore the neural underpinnings for neurocognitive (dys)function in this population.

Keywords: brain-behavior relationships in pediatric CKD; fMRI; pediatric chronic kidney disease.

Conflict of interest statement

Financial Disclosure and Conflict of Interest Statements: None.

Copyright © 2021 Elsevier Inc. All rights reserved.

Figures

Figure 1.

Horizontal sections showing mean activation above z = 2.3 for control participants (above) and CKD patients (below) during the encoding phase.

Figure 2.

Horizontal sections showing the comparative activation patterns for both groups during the encoding phase where Controls > CKD (encode phase, z = 2.0, p = 0.05).

Figure 3.

Horizontal sections showing the comparative activation patterns for both groups during the encoding phase where CKD > Controls (encode phase, z = 2.0, p

Figure 4.

Group comparisons of the time course of mean percent signal change in the superior parietal lobule during the encoding phase.

Figure 5.

Group comparisons of the time course of mean percent signal change in the superior occipital gyrus during the encoding phase.

Figure 6.

Horizontal sections showing mean activation above z = 2.3 for control participants (above) and CKD patients (below) during the retrieval phase.

Figure 7.

Horizontal sections showing the comparative activation patterns for both groups during the retrieval phase where Controls > CKD (retrieval phase, z = 2.0, p

Figure 8.

Horizontal sections showing the comparative activation patterns for both groups during the retrieval phase where CKD > controls (retrieval phase, z = 2.0, p