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终末期肾病患者单次透析过程中大脑固有活动改变及记忆功能改善。

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

机构信息

Department of Medical Imaging, First Affiliated Hospital of Xi'an, Jiaotong University, No. 277, West Yanta Road, Xi'an, 710061, Shaanxi-Province, People's Republic of China.

Department of Medical Imaging, Shaanxi Nuclear Geology 215 Hospital, Xianyang, People's Republic of China.

出版信息

Brain Imaging Behav. 2018 Dec;12(6):1640-1649. doi: 10.1007/s11682-018-9828-x.

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.

摘要

记忆缺陷被认为对接受透析治疗的终末期肾病(ESRD)患者的自我管理、饮食限制和治疗方案有很大影响。本研究旨在探讨 ESRD 患者在单次透析过程中透析前(T1)和透析后 24 小时(T2)的自发脑活动及其与记忆表现的关系。在 T1 时,23 例 ESRD 患者和 25 名匹配的健康对照者(HCs)接受功能磁共振成像(fMRI)扫描,所有患者均在 T2 时接受扫描。采用低频振幅(ALFF)和局部一致性(ReHo)方法评估两组之间的自发脑活动。采用听觉言语学习测验-华山版(AVLT-H)评估记忆功能。与 HCs 相比,ESRD 组在 T1 时即时回忆总得分(IR-S)、短期延迟回忆得分(SR-S)和长期延迟回忆得分(LR-S)显著降低。IR-S、SR-S、LR-S 和识别得分(REC-S)在 T2 时显著增加。与 T1 时的 HCs 相比,ESRD 患者的平均低频振幅(mALFF)值较低,主要位于背外侧前额叶皮层(DLPFC)、内侧额回和楔前叶。T1 时还发现双侧颞下回和左侧海马的 ReHo 较高,右侧中央前回和前扣带回的 ReHo 较低。在透析过程中,DLPFC 和楔前叶的 mALFF 值显著增加,而 ReHo 区域没有显著差异。此外,DLPFC 的 mALFF 值增加与 IR-S 的改善呈显著正相关。我们的结果表明,DLPFC 区域的局部自发性活动增加可能反映了单次透析治疗后记忆表现的改善,这可能为血液透析对单次透析过程中自发脑功能的影响提供新的见解。

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