Effect of Kidney Dysfunction on Cortical Thinning in Patients with Probable Alzheimer's Disease Dementia

Article type: Research Article

Authors: Cho, Eun Bin^a | Seo, Sang Won^{a; *} | Kim, HoJeong^b | Lee, Jong-Min^c | Yoon, Uicheul^d | Im, Kiho^e | Kim, Geon Ha^a | Noh, Young^a | Cho, Hanna^a | Yoon, Cindy W.^a | Kim, Hee Jin^a | Na, Duk L.^a

Affiliations: [a] Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea | [b] Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea | [c] Department of Biomedical Engineering, Hanyang University, Seoul, Korea | [d] Department of Biomedical Engineering, Catholic University of Daegu, Seoul, Korea | [e] Division of Newborn Medicine, Children's Hospital Boston, Harvard Medical School, Boston, MA, USA

Correspondence: [*] Correspondence to: Sang Won Seo, Department of Neurology, Sungkyunkwan University, Samsung Medical Center, 50 Irwon-dong, Gangnam-gu, Seoul 135-710, Korea. Tel.: +82 2 3410 1233/3599; Fax: +82 2 3410 0052; E-mail: sangwonseo@empal.com.

Abstract: There are some studies identifying the association between kidney dysfunction and cognitive impairment through various mechanisms including small vessel disease. However, results concerning the relationship between kidney dysfunction and cortical atrophy have been inconsistent. Thus, we aimed to evaluate the relationship among kidney dysfunction, small vessel disease, and cortical thinning in probable Alzheimer's disease (AD) dementia patients. Patients consisted of 162 subjects with probable AD dementia who underwent high-resolution T1-weighted volumetric magnetic resonance imaging (MRI) scans using the same scanner. The estimated glomerular filtration rate (GFR) was calculated and divided into the quartiles of patients for comparison. Volume of white matter hyperintensities (WMH) was automatically measured. Two neurologists counted the number of lacunes. Cortical thickness was measured using a surface-based method. GFR was not associated with WMH and the number of lacunes. However, the lowest quartile group of GFR (GFR 1) had cortical thinning in each lobe, compared to the highest quartile group of GFR (GFR 4). The topography of cortical thinning in the GFR 1 group was distributed predominantly in temporoparietal regions, compared to GFR 4. After further adjustment of small vessel disease MRI markers, the association between GFR and the cortical thinning remained. Our findings suggested that kidney dysfunction, represented by GFR, was related to temporoparietal thinning independent of small vessel disease in probable AD dementia patients.

Keywords: Alzheimer's disease, cortical thinning, glomerular filtration rate, kidney function

DOI: 10.3233/JAD-2012-121180

Journal: Journal of Alzheimer's Disease, vol. 33, no. 4, pp. 961-968, 2013