Altered intrinsic brain activity and memory performance improvement in patients with end-stage renal disease during a single dialysis session

Abstract

Memory deficits are considered to have a great influence on self-management, dietary restriction and therapeutic regimen for end-stage renal disease (ESRD) patients with dialysis treatment. This study was aim to investigate the spontaneous brain activity and its relationship with memory performance in ESRD patients before dialysis (T1) and after 24 h (T2) during a single dialysis session. 23 ESRD patients and 25 matched healthy controls (HCs) were scanned using functional magnetic resonance imaging (fMRI) at T1, and all patients were also scanned at T2. Amplitude of low-frequency fluctuation (ALFF) and regional homogeneity (ReHo) methods were used to evaluate the spontaneous brain activity between two groups. The Auditory Verbal Learning Test-Huashan version (AVLT-H) was performed to assess memory function. Compared with HCs, ESRD group showed a significant decreases in the immediate recall total score (IR-S), short-term delayed recall score (SR-S), and long-term delayed recall score (LR-S) at T1. IR-S, SR-S, LR-S and recognition score (REC-S) were significantly increased at T2. Compared with HCs at T1, ESRD patients showed that the lower mean ALFF (mALFF) values were mainly located in dorsolateral prefrontal cortex (DLPFC), medial frontal gyrus, and precuneus. Higher ReHo in the bilateral inferior temporal gyrus and left hippocampus and lower ReHo in the right precentral gyrus, anterior cingulate cortex were found at T1 too. The mALFF values of the DLPFC and precuneus were significantly increased during a dialysis session, while no significantly difference of ReHo region was found. Furthermore, the increased mALFF values of the DLPFC were significantly positively correlated with the improvement in the IR-S. Our results indicated that increased regional spontaneous activity of the DLPFC may reflect memory performance improvement after a single dialysis treatment, which may provide insight into the effect of hemodialysis on spontaneous brain function during a single dialysis session.

Alterations of Spontaneous Brain Activity in Hemodialysis Patients

“…CVLT is widely used to assess declarative verbal memory functions(Chepenik et al, 2012 ). The result of our study is identical to the result by Li et al ( 2018 ), who found that the ESRD group showed poor performance in the immediate recall total score, short-term delayed recall score, and long-term delayed recall score. Free-recall might be an important aspect of memory dysfunction in hemodialysis patients.…”

“…The DMN is involved in multiple brain functions including memory, visuality, and auditory attention, motor performance, and language processing (Buckner et al, 2008 ; Kim, 2012 ). Impairment of these neurocognitive areas has been found to lead to significant impairment in ESRD patients irrespective of whether they are receiving hemodialysis or peritoneal dialysis (Luo et al, 2016 ; Li et al, 2018 ). As a pivotal component of the DMN, the precuneus is closely associated with integrated tasks such as keeping wakefulness and the regulation of visual-spatial episodic memory (Buckner et al, 2009 ).…”

“…The posterior cingulate cortex, precuneus, medial prefrontal cortex, and inferior parietal lobule are the main components of the DMN. However, as far as we are concerned, only several resting-state functional MR imaging studies (Li et al, 2014 , 2018 ; Shi et al, 2019 ) have been performed in hemodialysis ESRD patients. Li et al ( 2014 ) demonstrated that normal regional homogeneity change was mainly found in the memory and cognition associated cortical regions in ESRD patients.…”

Disturbed neurovascular coupling in hemodialysis patients

“…As expected, there was a close relationship between CBF and brain metabolism, including glucose utilization, oxygen consumption, and aerobic glycolysis (Vaishnavi et al, 2010). Altered cerebral perfusion or neuronal activity in cerebral cortex was detected using only unimodal neuroimaging technique in several previous studies Peng et al, 2018). However, these results could not fully reflect their close coupling situations.…”

Preferentially Disrupted Core Hubs Within the Default-Mode Network in Patients With End-Stage Renal Disease: A Resting-State Functional Magnetic Resonance Imaging Study

“…Recent studies have shown that the DMN functional alterations induced by ESRD are not limited to regional homogeneity (ReHo) (17) and amplitude of low-frequency fluctuation (ALFF) (18) changes; they are also manifested as impaired FC in independent component analysis (ICA) (19), seed-based FC analysis (20,21), and graph theory-based analysis (22,23). Most of these functional abnormalities involve the parietal lobe, PCC, Pcu, and medial frontal lobe.…”