Regional Homogeneity Changes in Hemodialysis Patients with End Stage Renal Disease: In Vivo Resting-State Functional MRI Study

Abstract

ObjectiveTo prospectively investigate and detect early cerebral regional homogeneity (ReHo) changes in neurologically asymptomatic patients with end stage renal disease (ESRD) using in vivo resting-state functional MR imaging (Rs-fMRI).MethodsWe enrolled 20 patients (15 men, 5 women; meanage, 37.1 years; range, 19–49 years) with ESRD and 20 healthy controls (15 men, 5 women; mean age, 38.3 years; range, 28–49 years). The mean duration of hemodialysis for the patient group was 10.7±6.4 monthes. There was no significant sex or age difference between the ESRD and control groups. Rs-fMRI was performed using a gradient-echo echo-planar imaging sequence. ReHo was calculated using software (DPARSF). Voxel-based analysis of the ReHo maps between ESRD and control groups was performed with a two-samples t test. Statistical maps were set at P value less than 0.05 and were corrected for multiple comparisons. The Mini-Mental State Examination (MMSE) was administered to all participants at imaging.ResultsReHo values were increased in the bilateral superior temporal gyrus and left medial frontal gyrus in the ERSD group compared with controls, but a significantly decreased ReHo value was found in the right middle temporal gyrus. There was no significant correlation between ReHo values and the duration of hemodialysis in the ESRD group. Both the patients and control subjects had normal MMSE scores (≥28).ConclusionsOur finding revealed that abnormal brain activity was distributed mainly in the memory and cognition related cotices in patients with ESRD. The abnormal spontaneous neuronal activity in those areas provide information on the neural mechanisms underlying cognitive impairment in patients with ESRD, and demonstrate that Rs-fMRI with ReHo analysis is a useful non-invasive imaging tool for the detection of early cerebral ReHo changes in hemodialysis patients with ESRD.

Abnormal Intrinsic Brain Activity Patterns in Patients with End-Stage Renal Disease Undergoing Peritoneal Dialysis: A Resting-State Functional MR Imaging Study

“…Results of several previous studies have shown abnormalities in spontaneous brain activity in the DMN regions in patients with ESRD (20)(21)(22). However, the effect of the specific dialysis modality on the DMN in patients with ESRD has not been assessed to date.…”

“…Elevated serum urea, creatinine, and lowered hemoglobin levels affect spontaneous brain activity in patients with ESRD. (20)(21)(22) have been performed in patients with ESRD. Authors of these studies did not investigate the effect of the specific dialysis modality on spontaneous brain activity in patients with ESRD, because they included patients undergoing hemodialysis and PD and those not undergoing dialysis.…”

Screening of Cognitive Impairment in the Dialysis Population: A Scoping Review

“…There were 46 studies meeting the inclusion criteria for final analysis [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55]. An overview of the reviewed articles is presented in Table 2.…”

“…The test scores were reported as a continuous variable in their statistical tests. One of the studies, reporting the cognitive scores in the context of detecting early cerebral regional homogeneity changes in neurologically asymptomatic patients, found that none of the 20 patients aged <50 years had an abnormal MMSE [33]. In the remaining 13 studies, the prevalence of cognitive impairment varied from 6.6% [43] to 51% [11] with MMSE as the screening tool and from 16% [46] to 39.7% [20] with 3MS as the screening tool.…”

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

“…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).…”