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Non\u2010dialysis patients with chronic kidney disease (CKD) exhibit cognitive decline, but the underlying pathological mechanisms are unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The prospective study involved 53 patients with stage 1\u20133a CKD (CKD1\u20133a), 78 patients with stage 3b\u20135 CKD (CKD3b\u20135), and 52 healthy controls (HC). Our investigation involved voxel\u2010based assessments of both global and regional BOLD signal characteristics. Additionally, we explored the correlations between neuroimaging indices, Montreal Cognitive Assessment (MoCA) scores, and clinical laboratory findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Compared to HC, the CKD3b\u20135 and CKD1\u20133a groups exhibited lower ALLF and ReHo in the default mode network (DMN), higher CBF in bilateral hippocampus (HIP), higher susceptibility values in bilateral caudate nucleus (CAU) and putamen (PUT), and lower susceptibility values in bilateral HIP. At the global level, the coupling coefficients were lower in CKD1\u20133a and CKD3b\u20135 groups than in HC. At the ROI level, the CBF\u2010ALFF and CBF\u2010ReHo coupling in HIP and basal ganglia regions were lower in CKD3b\u20135 groups than in the CKD1\u20133a group. Most importantly, susceptibility\u2010ALFF in ANG.R may mediate the effects of phosphorus on cognitive decompensation in patients with CKD1\u20103a.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010dialysis patients with CKD exhibit abnormal NCV, which is associated with the cognitive decline. Specifically, the susceptibility\u2010ALFF may serve as a valuable biomarker for early assessment of cognitive decline in CKD, offering insights into the pathogenesis of cognitive decline in CKD.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.70151","type":"journal-article","created":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T07:29:12Z","timestamp":1733470152000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Combination of rs\u2010fMRI, QSM, and ASL Reveals the Cerebral Neurovascular Coupling Dysfunction Is Associated With Cognitive Decline in Patients With Chronic Kidney Disease"],"prefix":"10.1111","volume":"30","author":[{"given":"Lijun","family":"Song","sequence":"first","affiliation":[{"name":"Department of Radiology, Beijing Friendship Hospital Capital Medical University  Beijing 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