Neurovascular decoupling is associated with glymphatic system dysfunction in patients on dialysis

Motivation: Cognitive impairment in dialysis patients may be linked to decreased neurovascular coupling (NVC) and glymphatic system dysfunction. However, their relationship remains unclear. Goal(s): To investigate the interactions between NVC and glymphatic system function in dialysis patients compared to healthy controls. Approach: We assessed neurovascular coupling using the ALFF-CBF coupling coefficient and evaluated glymphatic system function through the DTI-ALPS index in 56 peritoneal dialysis patients, 54 hemodialysis patients, and 52 healthy controls. Results: Dialysis patients exhibited reduced NVC and glymphatic function. However, a significant correlation between neurovascular decoupling and glymphatic dysfunction was consistently observed in dialysis groups. Impact: This research highlights critical interactions between neurovascular coupling and glymphatic system function, providing insights that could inform therapeutic strategies for cognitive impairment in dialysis patients.