Neurovascular coupling dysfunction in end-stage renal disease patients related to cognitive impairment

Abstract

We aimed to investigate the neurovascular coupling (NVC) dysfunction in end-stage renal disease (ESRD) patients related with cognitive impairment. Twenty-five ESRD patients and 22 healthy controls were enrolled. To assess the NVC dysfunctional pattern, resting-state functional MRI and arterial spin labeling were explored to estimate the coupling of spontaneous neuronal activity and cerebral blood perfusion based on amplitude of low-frequency fluctuation (ALFF)-cerebral blood flow (CBF), fractional ALFF (fALFF)-CBF, regional homogeneity (ReHo)-CBF, and degree centrality (DC)-CBF correlation coefficients. Multivariate partial least-squares correlation and mediation analyses were used to evaluate the relationship among NVC dysfunctional pattern, cognitive impairment and clinical characteristics. The NVC dysfunctional patterns in ESRD patients were significantly decreased in 34 brain regions compared with healthy controls. The decreased fALFF-CBF coefficients in the cingulate gyrus (CG) were associated positively with lower kinetic transfer/volume urea (Kt/V) and lower short-term memory scores, and were negatively associated with higher serum urea. The relationship between Kt/V and memory deficits of ESRD patients was partially mediated by the fALFF-CBF alteration of the CG. These findings reveal the NVC dysfunction may be a potential neural mechanism for cognitive impairment in ESRD. The regional NVC dysfunction may mediate the impact of dialysis adequacy on memory function.

Early disturbance of dynamic synchronization and neurovascular coupling in cognitively normal Parkinson’s disease

“…The ratio of blood supply to neuronal activity could comprehensively depict the NVU modulations in voxel-wise manner and has been introduced as a quantitative imaging marker for cognitive dysfunction assessment. 35,46,47 In accordance with previous investigations utilizing BOLD 48,49 or ASL, 50 the present study obtained significantly altered ReHo and CBF in the vulnerable regions that involved in the management of movement coordination (putamen), control of motor initiation and execution (SMA), and modulation of sensorimotor integration (PG) for PD patients at voxel level. Given that regional hyper-metabolism corresponds to synaptic activation regardless of its excitatory or inhibitory properties, 51 this inverse trend of NVU indicated that the decreased neuronal synchronization (lower ReHo) in motor-related regions is ascribed to the inhibitory effect that is activated via high metabolic supply (high z-CBF).…”

K-Means Clustering Algorithm–Based Functional Magnetic Resonance for Evaluation of Regular Hemodialysis on Brain Function of Patients with End-Stage Renal Disease

“…Traditional and Improved K-Means Algorithm and Mean Shift Algorithm. The mean shift algorithm [24] was introduced and compared with the improved and traditional kmeans algorithms in the term of segmentation error rate, and the results are illustrated in Figure 5. It was found that among the three algorithms, the segmentation error rate was the lowest for the improved k-means algorithm proposed in this research, which was 16.3%; the highest segmentation error rate was found in the traditional k-means algorithm (25.33%); and that of the mean shift algorithm was centered at 19.2%.…”

Aberrant brain gray matter and functional networks topology in end stage renal disease patients undergoing maintenance hemodialysis with cognitive impairment

“…Functional imaging techniques, such as resting-state functional magnetic resonance imaging (rs-fMRI) and arterial spin labeling ( Zheng et al, 2016 ), have been utilized to detect brain functional alterations in ESRD. Recently, Li et al (2021) investigated disrupted neurovascular coupling in ESRD patients undergoing hemodialysis and revealed it to be a potential neural mechanism for CI. Moreover, rs-fMRI can detect low-frequency (0.01–0.08 Hz) fluctuations in blood-oxygen-level-dependent (BOLD) signals and can be used to investigate spontaneous neural activity at rest ( Barkhof et al, 2014 ).…”