Cognitive function and white matter changes associated with renal transplantation

Aditi Gupta, Rebecca J. Lepping, Alan S.L. Yu, Rodrigo D. Perea, Robyn A. Honea, David K Johnson, William M. Brooks, Jeffrey M. Burns

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Background: End-stage renal disease (ESRD) is a disease with an aging population and a high prevalence of cognitive impairment affecting quality of life, health care costs and mortality. Structural changes in the brain with decreased white matter integrity have been observed in ESRD. Understanding the changes in cognition and associated changes in brain structure after renal transplantation can help define the mechanisms underlying cognitive impairment in ESRD. Methods: We conducted a prospective, observational cohort study in ESRD patients listed for renal transplantation and followed them post-transplantation. We assessed their cognitive function with a battery of neuropsychological tests and brain white matter integrity with diffusion tensor imaging (DTI) both before transplant and 3 months after transplant. Results: Eleven patients, aged 56.5 ± 10.7 years, completed the study. Cognitive measures of memory and executive function improved after the transplant, specifically on tests of logical memory I (p = 0.004), logical memory II (p = 0.003) and digit symbol (p < 0.0001). DTI metrics also improved post the transplant with an increase in fractional anisotropy (p = 0.01) and decrease in mean diffusivity (p = 0.004). These changes were more prominent in tracts associated with memory and executive function. Conclusions: Cognitive function, particularly memory and executive function, improve post the transplant with concurrent improvements in white matter integrity in tracts associated with memory and executive function. These data suggest that abnormalities in cognition and brain structure seen in the ESRD population are at least partially reversible.

Original languageEnglish (US)
Pages (from-to)50-57
Number of pages8
JournalAmerican Journal of Nephrology
Volume43
Issue number1
DOIs
StatePublished - Mar 1 2016
Externally publishedYes

Keywords

  • Brain magnetic resonance imaging
  • Brain white matter integrity
  • Cognitive impairment
  • Diffusion tensor imaging
  • End-stage renal disease
  • Fractional anisotropy
  • Renal transplantation

ASJC Scopus subject areas

  • Nephrology

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  • Cite this

    Gupta, A., Lepping, R. J., Yu, A. S. L., Perea, R. D., Honea, R. A., Johnson, D. K., Brooks, W. M., & Burns, J. M. (2016). Cognitive function and white matter changes associated with renal transplantation. American Journal of Nephrology, 43(1), 50-57. https://doi.org/10.1159/000444334