Association between glymphatic dysfunction and cognitive impairment in patients with hemodialysis

Motivation: While glymphatic system dysfunction is closely linked to dementia, its role in patients with hemodialysis (HD) remains unclear. Goal(s): To evaluate the relationship between glymphatic function, cognitive performance, and clinical characteristics in HD patients. Approach: Multimodal approaches were utilized, including CPV, BOLD-CSF coupling, and DTI-ALPS index, to evaluate to evaluate glymphatic function in HD patients and healthy controls, and to investigate their correlation with cognitive performance. Results: HD patients exhibited impaired glymphatic function, indicated by increased CPV and decreased DTI-ALPS index. Importantly, the DTI-ALPS index was correlated with cognitive performance. Glymphatic dysfunction was an underlying mechanism account for cognitive impairment in HD patients. Impact: Multimodal neuroimaging techniques could provide non-invasive assessment of glymphatic dysfunction in HD patients, providing new insights into the pathophysiology of cognitive impairment in HD patients.