Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Cortical thickness of the rostral anterior cingulate gyrus is associated with frailty in patients with end-stage renal disease undergoing hemodialysis in Korea: a cross-sectional study

  • Sang Hyun Jung (Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Jong Soo Oh (Department of Psychiatry, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • So-Young Lee (Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine) ;
  • Hye Yun Jeong (Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine)
  • Received : 2022.12.19
  • Accepted : 2023.01.29
  • Published : 2023.10.31
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Abstract

Background: Frailty is defined as a condition of being weak and delicate, and it represents a state of high vulnerability to adverse health outcomes. Recent studies have suggested that the cingulate gyrus is associated with frailty in the elderly population. However, few imaging studies have explored the relationship between frailty and the cingulate gyrus in patients with end-stage renal disease (ESRD) undergoing hemodialysis. Methods: Eighteen right-handed patients with ESRD undergoing hemodialysis were enrolled in the study. We used the FreeSurfer software package to estimate the cortical thickness of the regions of interest, including the rostral anterior, caudal anterior, isthmus, and posterior cingulate gyri. The Beck Depression Inventory, Beck Anxiety Inventory, and laboratory tests were also conducted. Results: The cortical thickness of the right rostral anterior cingulate gyrus (ACG) was significantly correlated with the Fried frailty index, age, and creatinine level. Multiple regression analysis indicated that the cortical thickness of the right rostral ACG was associated with frailty after controlling for age and creatinine level. Conclusion: Our results indicate that the cortical thickness of the rostral ACG may be associated with frailty in patients with ESRD on hemodialysis and that the rostral ACG may play a role in the frailty mechanism of this population.

Keywords

Acknowledgement

This research was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C2750).

References

  1. Lee SY, Yang DH, Hwang E, Kang SH, Park SH, Kim TW, et al. The prevalence, association, and clinical outcomes of frailty in maintenance dialysis patients. J Ren Nutr 2017;27:106-12. https://doi.org/10.1053/j.jrn.2016.11.003
  2. Painter P, Roshanravan B. The association of physical activity and physical function with clinical outcomes in adults with chronic kidney disease. Curr Opin Nephrol Hypertens 2013; 22:615-23. https://doi.org/10.1097/MNH.0b013e328365b43a
  3. Roshanravan B, Khatri M, Robinson-Cohen C, Levin G, Patel KV, de Boer IH, et al. A prospective study of frailty in nephrology-referred patients with CKD. Am J Kidney Dis 2012;60:912-21. https://doi.org/10.1053/j.ajkd.2012.05.017
  4. Kooman JP, Kotanko P, Schols AM, Shiels PG, Stenvinkel P. Chronic kidney disease and premature ageing. Nat Rev Nephrol 2014;10:732-42. https://doi.org/10.1038/nrneph.2014.185
  5. Johansen KL, Chertow GM, Jin C, Kutner NG. Significance of frailty among dialysis patients. J Am Soc Nephrol 2007;18: 2960-7. https://doi.org/10.1681/ASN.2007020221
  6. McAdams-DeMarco MA, Suresh S, Law A, Salter ML, Gimenez LF, Jaar BG, et al. Frailty and falls among adult patients undergoing chronic hemodialysis: a prospective cohort study. BMC Nephrol 2013;14:224.
  7. Wilhelm-Leen ER, Hall YN, K Tamura M, Chertow GM. Frailty and chronic kidney disease: the Third National Health and Nutrition Evaluation Survey. Am J Med 2009;122:664-71. https://doi.org/10.1016/j.amjmed.2009.01.026
  8. Jacobs JM, Cohen A, Ein-Mor E, Maaravi Y, Stessman J. Frailty, cognitive impairment and mortality among the oldest old. J Nutr Health Aging 2011;15:678-82. https://doi.org/10.1007/s12603-011-0096-3
  9. Fried LP, Ferrucci L, Darer J, Williamson JD, Anderson G. Untangling the concepts of disability, frailty, and comorbidity: implications for improved targeting and care. J Gerontol A Biol Sci Med Sci 2004;59:255-63. https://doi.org/10.1093/gerona/59.3.M255
  10. Ni Mhaolain AM, Fan CW, Romero-Ortuno R, Cogan L, Cunningham C, Kenny RA, et al. Frailty, depression, and anxiety in later life. Int Psychogeriatr 2012;24:1265-74. https://doi.org/10.1017/S1041610211002110
  11. Qiu Y, Lv X, Su H, Jiang G, Li C, Tian J. Structural and functional brain alterations in end stage renal disease patients on routine hemodialysis: a voxel-based morphometry and resting state functional connectivity study. PLoS One 2014;9:e98346.
  12. Papoiu AD, Emerson NM, Patel TS, Kraft RA, Valdes-Rodriguez R, Nattkemper LA, et al. Voxel-based morphometry and arterial spin labeling fMRI reveal neuropathic and neuroplastic features of brain processing of itch in end-stage renal disease. J Neurophysiol 2014;112:1729-38. https://doi.org/10.1152/jn.00827.2013
  13. Hadland KA, Rushworth MF, Gaffan D, Passingham RE. The effect of cingulate lesions on social behaviour and emotion. Neuropsychologia 2003;41:919-31. https://doi.org/10.1016/S0028-3932(02)00325-1
  14. Sutherland RJ, Whishaw IQ, Kolb B. Contributions of cingulate cortex to two forms of spatial learning and memory. J Neurosci 1988;8:1863-72. https://doi.org/10.1523/JNEUROSCI.08-06-01863.1988
  15. Hayden BY, Platt ML. Neurons in anterior cingulate cortex multiplex information about reward and action. J Neurosci 2010; 30:3339-46. https://doi.org/10.1523/JNEUROSCI.4874-09.2010
  16. Paus T. Primate anterior cingulate cortex: where motor control, drive and cognition interface. Nat Rev Neurosci 2001;2:417-24. https://doi.org/10.1038/35077500
  17. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 2001;56:M146-56. https://doi.org/10.1093/gerona/56.3.M146
  18. Wang YP, Gorenstein C. Assessment of depression in medical patients: a systematic review of the utility of the Beck Depression Inventory-II. Clinics (Sao Paulo) 2013;68:1274-87. https://doi.org/10.6061/clinics/2013(09)15
  19. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 1988;56:893-7. https://doi.org/10.1037/0022-006X.56.6.893
  20. Hagler DJ Jr, Saygin AP, Sereno MI. Smoothing and cluster thresholding for cortical surface-based group analysis of fMRI data. Neuroimage 2006;33:1093-103. https://doi.org/10.1016/j.neuroimage.2006.07.036
  21. Kim JC, Kalantar-Zadeh K, Kopple JD. Frailty and protein-energy wasting in elderly patients with end stage kidney disease. J Am Soc Nephrol 2013;24:337-51. https://doi.org/10.1681/ASN.2012010047
  22. Wei K, Nyunt MS, Gao Q, Wee SL, Yap KB, Ng TP. Association of frailty and malnutrition with long-term functional and mortality outcomes among community-dwelling older adults: results from the Singapore Longitudinal Aging Study 1.JAMA Netw Open 2018;1:e180650.
  23. Wei K, Nyunt MS, Gao Q, Wee SL, Ng TP. Frailty and malnutrition: related and distinct syndrome prevalence and association among community-dwelling older adults: Singapore Longitudinal Ageing Studies. J Am Med Dir Assoc 2017;18:1019-28. https://doi.org/10.1016/j.jamda.2017.06.017
  24. Zhang Z, Pereira SL, Luo M, Matheson EM. Evaluation of blood biomarkers associated with risk of malnutrition in older adults: a systematic review and meta-analysis. Nutrients 2017; 9:829.
  25. Omran ML, Morley JE. Assessment of protein energy malnutrition in older persons, part II: laboratory evaluation. Nutrition 2000;16:131-40. https://doi.org/10.1016/S0899-9007(99)00251-8
  26. Canaud B, Granger Vallee A, Molinari N, Chenine L, Leray-Moragues H, Rodriguez A, et al. Creatinine index as a surrogate of lean body mass derived from urea Kt/V, pre-dialysis serum levels and anthropometric characteristics of haemodialysis patients. PLoS One 2014;9:e93286.
  27. Robertson DA, Savva GM, Kenny RA. Frailty and cognitive impairment: a review of the evidence and causal mechanisms. Ageing Res Rev 2013;12:840-51. https://doi.org/10.1016/j.arr.2013.06.004
  28. Lee YC. A study of the relationship between depression symptom and physical performance in elderly women. J Exerc Rehabil 2015;11:367-71. https://doi.org/10.12965/jer.150257
  29. Kang JY, Kim CH, Sung EJ, Shin HC, Shin WJ, Jung KH. The association between frailty and cognition in elderly women. Korean J Fam Med 2016;37:164-70. https://doi.org/10.4082/kjfm.2016.37.3.164
  30. Brigola AG, Rossetti ES, Dos Santos BR, Neri AL, Zazzetta MS, Inouye K, et al. Relationship between cognition and frailty in elderly: a systematic review. Dement Neuropsychol 2015;9:110-9. https://doi.org/10.1590/1980-57642015DN92000005
  31. Kurella M, Chertow GM, Luan J, Yaffe K. Cognitive impairment in chronic kidney disease. J Am Geriatr Soc 2004;52: 1863-9. https://doi.org/10.1111/j.1532-5415.2004.52508.x
  32. Cukor D, Peterson RA, Cohen SD, Kimmel PL. Depression in end-stage renal disease hemodialysis patients. Nat Clin Pract Nephrol 2006;2:678-87. https://doi.org/10.1038/ncpneph0359
  33. Kimmel PL, Peterson RA. Depression in end-stage renal disease patients treated with hemodialysis: tools, correlates, outcomes, and needs. Semin Dial 2005;18:91-7. https://doi.org/10.1111/j.1525-139X.2005.18209.x
  34. Maddock RJ, Garrett AS, Buonocore MH. Posterior cingulate cortex activation by emotional words: fMRI evidence from a valence decision task. Hum Brain Mapp 2003;18:30-41. https://doi.org/10.1002/hbm.10075
  35. Mayberg HS, Brannan SK, Mahurin RK, Jerabek PA, Brickman JS, Tekell JL, et al. Cingulate function in depression: a potential predictor of treatment response. Neuroreport 1997;8:1057-61. https://doi.org/10.1097/00001756-199703030-00048
  36. Devinsky O, Morrell MJ, Vogt BA. Contributions of anterior cingulate cortex to behaviour. Brain 1995;118(Pt 1):279-306. https://doi.org/10.1093/brain/118.1.279
  37. Chen WT, Chou KH, Liu LK, Lee PL, Lee WJ, Chen LK, et al. Reduced cerebellar gray matter is a neural signature of physical frailty. Hum Brain Mapp 2015;36:3666-76. https://doi.org/10.1002/hbm.22870
  38. Buchman AS, Yu L, Wilson RS, Schneider JA, Bennett DA. Association of brain pathology with the progression of frailty in older adults. Neurology 2013;80:2055-61. https://doi.org/10.1212/WNL.0b013e318294b462
  39. Murray AM, Tupper DE, Knopman DS, Gilbertson DT, Pederson SL, Li S, et al. Cognitive impairment in hemodialysis patients is common. Neurology 2006;67:216-23. https://doi.org/10.1212/01.wnl.0000225182.15532.40
  40. Cherng YG, Lin CS, Shih CC, Hsu YH, Yeh CC, Hu CJ, et al. Stroke risk and outcomes in patients with chronic kidney disease or end-stage renal disease: two nationwide studies. PLoS One 2018;13:e0191155.