#1719 Changes in cerebral blood flow and cognitive function before and one year after kidney transplantation: the VINTAGE study
Bibliographic record
Abstract
Abstract Background and Aims Chronic kidney disease (CKD) is a major independent risk factor for cerebrovascular events. We have previously demonstrated decreased cerebral blood flow (CBF) in dialysis patients and a high prevalence of mild cognitive impairment (MCI) associated with hippocampal atrophy and hyperhomocysteinemia (Kobayashi S, et al: Hypertens Res 2014, Hidaka S, et al: Sci Rep 2022, Maesato K, et al: PLoS One 2017). Kidney transplantation (KT) is known to reduce cerebrovascular events compared to dialysis. We investigated the impact of KT on CBF across different brain regions and its relationship with cognitive function, particularly in patients with pre-KT MCI. Method This study utilized data from the VINTAGE study, an ongoing observational cohort study. CBF was assessed using quantitative single-photon emission computed tomography (SPECT) before and one year after KT in 53 recipients (2016–2020). CBF was measured by level and region according to the Talairach brain atlas. Cognitive function was evaluated using the Montreal Cognitive Assessment (MoCA) before and one year after KT in 70 recipients (2017–2021). The primary endpoint for CBF was the mean difference before and after KT. The interaction between pre-KT MCI status and the effect of KT on MoCA scores (total and domain) was evaluated. Results KT significantly improved (normalized) blood flow in the anterior and middle cerebral arteries, with the most consistent improvements observed in the frontal lobe (left: -−0.12 [95% CI −0.18 to −0.05], P < .001; right: −0.13 [95% CI −0.21 to −0.05], P = .001). Subgroup analysis confirmed a consistent effect of KT on frontal lobe CBF regardless of risk factors. Regarding cognitive function, no significant change in MoCA total score was observed in the non-MCI group (27.6 ± 1.2 to 27.6 ± 1.6, P = .809). However, the MCI group showed significant improvement (22.9 ± 2.0 to 24.7 ± 2.0, P < .001). A significant interaction was found between pre-KT MCI status and the change in MoCA score (P < .001). Improvement was greatest in the visuospatial/executive domain (P = .008 for interaction). Conclusion KT contributes to the normalization of CBF, particularly in the anterior circulation and frontal lobe. KT also has a positive impact on cognitive function, especially in patients with pre-KT MCI. Future studies should investigate the relationship between specific cognitive impairments and CBF in each perfusion region to further elucidate the clinical significance of KT's CBF-improving effects.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".