The impact of hemodialysis on cognitive dysfunction in patients with end-stage renal disease: a resting-state functional MRI study

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• 作者：Hui Juan Chen ; Rongfeng Qi ; Xiang Kong ; Jiqiu Wen ; Xue Liang…
• 关键词：End ; stage renal disease (ESRD) ; Hemodialysis (HD) ; Resting ; state functional MR imaging (rs ; fMRI) ; Regional homogeneity (ReHo) ; Functional connectivity
• 刊名：Metabolic Brain Disease
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：30
• 期：5
• 页码：1247-1256
• 全文大小：914 KB
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• 作者单位：Hui Juan Chen (1)
  Rongfeng Qi (1)
  Xiang Kong (1)
  Jiqiu Wen (2)
  Xue Liang (1)
  Zhe Zhang (2)
  Xue Li (2)
  Guang Ming Lu (1)
  Long Jiang Zhang (1)
  
  1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
  2. National Clinical Research Center of Kidney Disease, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, 210002, China
  
• 刊物类别：Biomedical and Life Sciences
• 刊物主题：Biomedicine
  Neurosciences
  Neurology
  Biochemistry
  Oncology
  
• 出版者：Springer Netherlands
• ISSN：1573-7365

文摘

To investigate the effect of hemodialysis (HD) on cognitive dysfunction in patients with end-stage renal disease (ESRD) using resting-state functional MR imaging (rs-fMRI) with regional homogeneity (ReHo) and functional connectivity algorithms. The rs-fMRI data were acquired in 58 ESRD patients (HD patients, n--2, 22 male and 10 female, mean age 36.5?±-.6 years; non-HD ESRD patients, n--6, 16 male and 10 female, mean years of 35.6?±-.2) and 32 healthy controls (22 male and 10 female, mean years of 32.7?±-.8). A battery of neuropsychological and blood laboratory tests were prescribed. The Kendall’s coefficient of concordance (KCC) was used to measure ReHo for each subject. The ReHo maps were compared by using ANOVA tests among HD, non-HD, and healthy control groups. Regions showing ReHo differences between HD and non-HD patients were defined as seeds for further functional connectivity analysis. A multiple regression analysis was performed to evaluate the relationships between ReHo index and neuropsychological tests, serum creatinine and urea levels, disease and dialysis duration. Compared with healthy controls, both HD patients and non-HD patients showed decreased ReHo in the multiple areas of bilateral frontal, parietal and temporal lobes. Compared with the non-HD, HD patients showed decreased ReHo mainly in default mode network (DMN) including bilateral precuneus, posterior cingulate cortex, inferior parietal lobe, right postcentral gyrus, bilateral superior temporal gyri, right supramarginal gyrus and right angular gyrus. Some reduced ReHo brain regions correlated with some neuropsychological tests, serum creatinine and urea levels, and dialysis duration. Brain regions with ReHo reduction showed increased region-to-region functional network in HD patients compared with non-HD patients. Widespreadly decreased ReHo values were found in both HD and non-HD patients. Lower ReHo values mainly in the DMN correlated with cognition impairments were observed in HD patients compared with non-HD patients, while increased functional connectivity was found between these brain regions. HD might have an adverse effect on the cognitive function in ESRD patients. Keywords End-stage renal disease (ESRD) Hemodialysis (HD) Resting-state functional MR imaging (rs-fMRI) Regional homogeneity (ReHo) Functional connectivity