Possible Neuroprotective Effects of l-Carnitine on White-Matter Microstructural Damage and Cognitive Decline in Hemodialysis Patients.
- 2021-04-14
- Nutrients 13(4)
- Yuji Ueno
- Asami Saito
- Junichiro Nakata
- Koji Kamagata
- Daisuke Taniguchi
- Yumiko Motoi
- Hiroaki Io
- Christina Andica
- Atsuhiko Shindo
- Kenta Shiina
- Nobukazu Miyamoto
- Kazuo Yamashiro
- Takao Urabe
- Yusuke Suzuki
- Shigeki Aoki
- Nobutaka Hattori
- PubMed: 33919810
- DOI: 10.3390/nu13041292
Study Design
- Type
- Observational
- Population
- 14 hemodialysis patients and 10 age- and sex-matched controls
- Methods
- Patients grouped according to duration of l-carnitine treatment: (1) no or short-term l-carnitine treatment (NSTLC), and (2) long-term l-carnitine treatment (LTLC); novel diffusion magnetic resonance imaging (dMRI), laboratory and neuropsychological tests
- Duration
- no or short-term vs long-term (not explicitly defined in days/weeks/months in abstract, but implied by grouping)
- Rigorous Journal
Although l-carnitine alleviated white-matter lesions in an experimental study, the treatment effects of l-carnitine on white-matter microstructural damage and cognitive decline in hemodialysis patients are unknown. Using novel diffusion magnetic resonance imaging (dMRI) techniques, white-matter microstructural changes together with cognitive decline in hemodialysis patients and the effects of l-carnitine on such disorders were investigated. Fourteen hemodialysis patients underwent dMRI and laboratory and neuropsychological tests, which were compared across seven patients each in two groups according to duration of l-carnitine treatment: (1) no or short-term l-carnitine treatment (NSTLC), and (2) long-term l-carnitine treatment (LTLC). Ten age- and sex-matched controls were enrolled. Compared to controls, microstructural disorders of white matter were widely detected on dMRI of patients. An autopsy study of one patient in the NSTLC group showed rarefaction of myelinated fibers in white matter. With LTLC, microstructural damage on dMRI was alleviated along with lower levels of high-sensitivity C-reactive protein and substantial increases in carnitine levels. The LTLC group showed better achievement on trail making test A, which was correlated with amelioration of disorders in some white-matter tracts. Novel dMRI tractography detected abnormalities of white-matter tracts after hemodialysis. Long-term treatment with l-carnitine might alleviate white-matter microstructural damage and cognitive impairment in hemodialysis patients.
Research Insights
The LTLC group showed better achievement on trail making test A, which was correlated with amelioration of disorders in some white-matter tracts.
- Effect
- Beneficial
- Effect size
- Moderate
With LTLC, microstructural damage on dMRI was alleviated along with lower levels of high-sensitivity C-reactive protein and substantial increases in carnitine levels.
- Effect
- Beneficial
- Effect size
- Large
With LTLC, microstructural damage on dMRI was alleviated along with lower levels of high-sensitivity C-reactive protein and substantial increases in carnitine levels.
- Effect
- Beneficial
- Effect size
- Moderate
With LTLC, microstructural damage on dMRI was alleviated along with lower levels of high-sensitivity C-reactive protein and substantial increases in carnitine levels.
- Effect
- Beneficial
- Effect size
- Moderate