Decreased Neural Connectivity in the Default Mode Network Among Youth and Young Adults With Chronic Kidney Disease

  • John D. Herrington
    Address reprint requests to John D. Herrington, PhD, Center for Autism Research, The Children's Hospital of Philadelphia, Roberts Center for Pediatric Research, 5th floor, 2716 South Street, Philadelphia, PA 19146-2305.
    Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA

    Department of Child Psychiatry and Behavioral Science, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Erum A. Hartung
    Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA

    Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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  • Nina C. Laney
    Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA
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  • Stephen R. Hooper
    Department of Allied Health Sciences, School of Medicine, University of North Carolina School–Chapel Hill, Chapel Hill, NC
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  • Susan L. Furth
    Division of Nephrology, Children's Hospital of Philadelphia, Philadelphia, PA

    Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA

    Department of Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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      An increasing amount of literature has indicated that chronic kidney disease (CKD) is associated with cognitive deficits that increase with worsening disease severity. Although abnormalities in brain structure have been widely documented, few studies to date have examined the functioning of brain areas associated with the specific cognitive domains affected by CKD (namely, attention and executive functions). Furthermore, few studies have examined functional connectivity among CKD youth who are relatively early in the course of the disease. The present study used functional magnetic resonance imaging to examine the resting state connectivity in 67 youth with CKD (mean age, 17 y) and 58 age-matched healthy controls. Using seed-based multiple regression, decreased connectivity was observed within the anterior cingulate portion of the default mode network. In addition, decreased connectivity within the dorsolateral prefrontal cortex, paracingulate gyrus, and frontal pole were correlated significantly with disease severity. These data indicate that connectivity deficits in circuits implementing attentional processes may represent an early marker for cognitive decline in CKD.


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