Summary
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
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Article info
Footnotes
Current affiliation for Waverly Harrell, PhD: Psychiatric and Psychological Associates of Durham, Durham, NC
Financial support: Publication of this article was supported in part by the Chronic Kidney Disease in Children prospective cohort study. The Chronic Kidney Disease in Children study is funded by the National Institute of Diabetes and Digestive and Kidney Diseases, with additional funding from the National Institute of Child Health and Human Development, and the National Heart, Lung, and Blood Institute (U01 DK066143, U01 DK066174, U01 DK082194, and U01 DK066116). In addition, the study primary data collection was supported in part by the Renal Research Institute.
Conflict of interest statement: none.
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