Abnormal interaction between cognitive control network and affective network in patients with end-stage renal disease

Abstract

End-stage renal disease (ESRD) is a common complicated disorder that is generally associated with an altered central nervous system and cognitive impairment. Neuroimaging studies have recorded aberrant brain circuits in patients with ESRD that were closely associated with abnormal clinical manifestations. However, whether the altered interaction was within and/or between these circuits is largely unclear. We investigated brain topological organization and/or module interaction by employing resting-state functional magnetic resonance imaging (rs-fMRI) and modularity network analysis in 24 patients with ESRD and 20 age- and gender-matched healthy control (HC) subjects. Stroop task was used to evaluate the performance of cognitive control in all subjects. At the global level, ESRD patients exhibited significantly decreased global and local efficiency which were mainly related to abnormal functional connectivity of the amygdala and inferior frontal gyrus (IFG). Stepwise regression analysis was applied to estimate the relationships between network efficiency and blood biochemistry level (urea, creatine, phosphate, Ca, hematocrit, cystatin, hemoglobin levels, parathyroid hormone, K and Na), and only the hematocrit level was significantly associated with global efficiency in patients with ESRD. At the modular level, we discovered an aberrant brain interaction between the amygdala- and IFG-related circuits in the ESRD group, and the regional efficiency of the amygdala was observably relative to the performance of cognitive control in patients with ESRD. Our results suggested that ESRD exhibited aberrant brain functional topological organization and module-level interaction between the affective and cognitive control circuits, providing crucial insights into the pathophysiological mechanism of ESRD patients.

How Do You Feel Now? The Salience Network Functional Connectivity in End-Stage Renal Disease

“…One focus of this study was the SN due to its role on the brain end of the renal-brain axis. Our current findings were generally consistent with earlier reports, for example, recent studies have reported gray matter loss (Zhang et al, 2013), disrupted white matter microstructure (Mu et al, 2018a), elevated cerebral blood flow (CBF) (Jiang et al, 2016), and dysconnectivity (Mu et al, 2018b) in the SN in patients. The SN is engaged in identifying and responding to salient stimuli, as well as recruiting relevant largescale functional networks for advanced cognition (Chand and Dhamala, 2016).…”

“…In our study, ESRD patients reported cognitive decline, mainly in working memory, attention, processing speed, accompanied by depression, which was consistent with previous research (Dong et al, 2016). Recent rs-fMRI research also found that abnormal interaction between the SN and affective network, which laid the neural foundation of the abnormal interaction between depressive mood and cognitive control deficits in ESRD patients (Li et al, 2018;Mu et al, 2018b). And the FC between the right anterior insula and the right supramarginal gyrus significantly positively correlated with MoCA, which meant the decreased FC may predict the cognitive impairment in ESRD patients.…”

“…We identified that, in ESRD patients, there were significantly reduced FC pairs between the dACC and left AISL, right AISL and right SMG, left PISL and right MCC and left PCN, and left CBLM-VI and right MFG, which was consistent with previous structural neuroimaging research (Zhang et al, 2013;Mu et al, 2018b) and a recent perspective review (Chen et al, 2015(Chen et al, , 2017(Chen et al, , 2018. In ESRD patients, the accumulation of uremic toxin and inflammation are important to accelerate neurodegeneration and vascular injury (Chiu et al, 2019).…”

Abnormal rich club organization in end-stage renal disease patients before dialysis initiation and undergoing maintenance hemodialysis

“…Higher global efficiency seems to indicate effective integrity and rapid information propagation between and across remote brain regions [54,55]. For our earlier studies, decreased global efficiency has previously been reported in functional brain networks [56]. Here, the increased global efficiency in the structural network may suggest of self-regulation of the brain.…”

Abnormal rich club organization in end-stage renal disease patients before dialysis initiation and undergoing maintenance hemodialysis

“…Higher global efficiency seems to indicate effective integrity and rapid information propagation between and across remote brain regions [54,55]. For our earlier studies, decreased global efficiency has previously been reported in functional brain networks [56]. Here, increased global efficiency in the structural network may suggest self-regulation of the brain.…”