Differences of connectivity between ESRD patients with PD and HD

Abstract

Objectives The aim of this study was to investigate alterations in structural and functional brain connectivity between patients with end‐stage renal disease (ESRD) who were undergoing peritoneal dialysis (PD) and hemodialysis (HD). Methods We enrolled 40 patients with ESRD who were undergoing PD (20 patients) and HD (20 patients). We also enrolled healthy participants as a control group. All of the subjects underwent diffusion tensor imaging (DTI) and resting‐state functional magnetic resonance imaging (rs‐fMRI). Using data from the structural and functional connectivity matrix based on DTI and rs‐fMRI, we calculated several network measures using graph theoretical analysis. Results The measures of global structural connectivity were significantly different between the patients with ESRD who were undergoing PD and healthy subjects. The global efficiency and local efficiency in the patients with PD were significantly decreased compared with those in healthy participants. However, all of the measures of global structural connectivity in the patients with HD were not different from those in healthy participants. Conversely, in the global functional connectivity, the characteristic path length was significantly increased and the small‐worldness index was decreased in patients with HD. However, the measures of the global functional connectivity in the patients with PD were not different from those in healthy subjects. Conclusion This study revealed that alterations in structural and functional connectivity in patients who were undergoing PD and HD were different than those in healthy controls. These findings suggest that brain networks may be affected by different types of renal replacement therapy.

Changes of Brain Functional Connectivity in End-Stage Renal Disease Patients Receiving Peritoneal Dialysis Without Cognitive Decline

“…The other study performed graph theoretical analysis on both structural and functional connectivity. In global connectivity, patients with PD only showed decreased “structural” connectivity but not “functional” connectivity, while in local connectivity, patients with PD had variable changes (including increased and decreased connectivity) in BC over right frontal operculum, right inferior temporal, right temporal cortex pole, right occipital pole, right supracalcarine, left insular cortex, and left postcentral region ( 22 ). It was noted that most patients with PD in that study also had cognitive impairment, especially in frontal/executive function.…”

“…Compared to the healthy controls, only patients with HD but not patients with PD had significant changes in global functional connectivity. The authors concluded that the brain networks may be affected by different types of renal replacement therapy ( 22 ). Moreover, disruption of brain function may precede neurological symptoms.…”

Glymphatic Dysfunction in Patients With End-Stage Renal Disease

“…However, as vascular disease alone cannot explain the brain dysfunction and other neurological abnormalities in patients with ESRD, many studies have been conducted to identify other possible mechanisms underlying such abnormalities. Our previous study using graphic theoretical analysis showed that patients with ESRD had decreased structural and functional brain connectivity, and there was an association between brain connectivity and cognitive function ( 20 ). There were even changes in structural connectivity in asymptomatic patients with early chronic kidney disease (CKD) ( 21 ).…”

Gout Is Not Just Arthritis: Abnormal Cortical Thickness and Structural Covariance Networks in Gout

“…The global efficiency is defined as the inverse of the harmonic mean of the shortest path length between a node and all other nodes; it is a measure that reflects parallel information transmission and comprehensive processing capabilities ( 19 ). The reduction of this measure also appears in diseases such as mild cognitive impairment ( 53 ) and peritoneal dialysis patients ( 54 ).…”