Altered Pattern of Spontaneous Brain Activity in the Patients with End-Stage Renal Disease: A Resting-State Functional MRI Study with Regional Homogeneity Analysis

Abstract

PurposeTo investigate the pattern of spontaneous neural activity in patients with end-stage renal disease (ESRD) with and without neurocognitive dysfunction using resting-state functional magnetic resonance imaging (rs-fMRI) with a regional homogeneity (ReHo) algorithm.Materials and Methodsrs-fMRI data were acquired in 36 ESRD patients (minimal nephro-encephalopathy [MNE], n = 19, 13 male, 37±12.07 years; non-nephro-encephalopathy [non-NE], n = 17, 11 male, 38±12.13 years) and 20 healthy controls (13 male, 7 female, 36±10.27 years). Neuropsychological (number connection test type A [NCT-A], digit symbol test [DST]) and laboratory tests were performed in all patients. The Kendall's coefficient of concordance (KCC) was used to measure the regional homogeneity for each subject. The regional homogeneity maps were compared using ANOVA tests among MNE, non-NE, and healthy control groups and post hoc t -tests between each pair in a voxel-wise way. A multiple regression analysis was performed to evaluate the relationships between ReHo index and NCT-A, DST scores, serum creatinine and urea levels, disease and dialysis duration.ResultsCompared with healthy controls, both MNE and non-NE patients showed decreased ReHo in the multiple areas of bilateral frontal, parietal and temporal lobes. Compared with the non-NE, MNE patients showed decreased ReHo in the right inferior parietal lobe (IPL), medial frontal cortex (MFC) and left precuneus (PCu). The NCT-A scores and serum urea levels of ESRD patients negatively correlated with ReHo values in the frontal and parietal lobes, while DST scores positively correlated with ReHo values in the bilateral PCC/precuneus, MFC and inferior parietal lobe (IPL) (all P<0.05, AlphaSim corrected). No significant correlations were found between any regional ReHo values and disease duration, dialysis duration and serum creatinine values in ESRD patients (all P>0.05, AlphaSim corrected).ConclusionDiffused decreased ReHo values were found in both MNE and non-NE patients. The progressively decreased ReHo in the default mode network (DMN), frontal and parietal lobes might be trait-related in MNE. The ReHo analysis may be potentially valuable for elucidating neurocognitive abnormalities of ESRD patients and detecting the development from non-NE to MNE.

Brain functional connectivity and morphology changes in medication-overuse headache: Clue for dependence-related processes?

“…Moreover, this region was found anatomically altered in MOH patients (5). FC of the precuneus is known to be lateralized (29) and the right and left precuneus are differentially sensitive to aging (30) and diseases (31,32), with the left precuneus being more sensitive in right-handed subjects. We thus focused all analyses on left precuneus as all our subjects were right-handed.…”

Re-Establishing Brain Networks in Patients with ESRD after Successful Kidney Transplantation

“…However, this study only focused on the structural and functional connectivity changes in the default mode network 1 month after kidney transplantation. The effects of ESRD may be more global (20), and the potential involvement of other resting-state subnetworks warrants investigation. Thus, the purpose of this investigation is to examine the recovery patterns of seven resting-state subnetworks in patients with ESRD after kidney transplantation.…”

Altered long- and short-range functional connectivity in the patients with end-stage renal disease: a resting-state functional MRI study

“…In addition, we found decreased long-and short-range FCD in frontal (mainly) and parietal lobe. Many studies have found functional alteration of frontal and parietal lobe in patients with ESRD (Harciarek et al 2012;Liang et al 2013). Frontal and parietal lobe dysfunction is characterized clinically by decreased spontaneity, initiative, insight, judgment, abstraction, perseverance and response inhibition (Hirakata et al 1992).…”

“…Especially, resting-state fMRI (rsfMRI) has attracted more attention as a powerful tool to study brain activity in patients at resting state (Snyder and Raichle 2012). To our knowledge, only a few studies on neuropathological mechanism of cognitive impairment in patients with ESRD were carried out by using rs-fMRI (Liang et al 2013;Li et al 2014;Ni et al 2014). Liang et al found progressively decreased regional homogeneity in the default mode network (DMN), frontal and parietal lobes in patients with ESRD (Liang et al 2013).…”

“…To our knowledge, only a few studies on neuropathological mechanism of cognitive impairment in patients with ESRD were carried out by using rs-fMRI (Liang et al 2013;Li et al 2014;Ni et al 2014). Liang et al found progressively decreased regional homogeneity in the default mode network (DMN), frontal and parietal lobes in patients with ESRD (Liang et al 2013). Ni et al (2014) consequently focused on disruption of functional connectivity of DMN in these patients by using independent component analysis (ICA).…”