Chen Hui Juan, Qiu Jie, Fu Qingqing, Chen Feng
Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.
Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, China.
Front Hum Neurosci. 2020 Jul 15;14:278. doi: 10.3389/fnhum.2020.00278. eCollection 2020.
Cognitive impairment is prevalent in hemodialysis end-stage renal disease (ESRD) patients. It might be associated with poor prognosis. Nevertheless, the underlying mechanisms have not been completely clarified. This study explored spontaneous brain activity in ESRD patients on hemodialysis by using the amplitude of low-frequency fluctuation (ALFF). Nineteen ESRD patients on regular hemodialysis were included in this study. Eighteen age-, sex- and education level-matched volunteers were enrolled as the healthy control group. All participants had resting-state functional MRI scanning, neuropsychological tests, and laboratory testing. ALFF was used for assessing intrinsic brain activity. Independent samples -test was used for obtaining group differences. Spearman correlation analysis was applied to assess the association between ALFF changes, neuropsychological, and clinical indices. Compared to the healthy control group, hemodialysis patients showed decreased ALFF in the precuneus, right angular gyrus/inferior lobule as well as increased ALFF in the left parahippocampus/hippocampus and right precentral/postcentral gyrus. The ALFF abnormalities in these regions were closely associated with hemoglobin levels. Also, increased ALFF in the left parahippocampus/hippocampus showed a negative correlation with the score of long-delayed free recall. Hemodialysis patients had aberrant ALFF in the default mode network (DMN) regions, particularly in the precuneus and parahippocampus/hippocampus, which may be correlated with neuropathological mechanisms involved in hemodialysis.
认知障碍在血液透析终末期肾病（ESRD）患者中普遍存在。它可能与预后不良有关。然而，其潜在机制尚未完全阐明。本研究通过使用低频振幅（ALFF）来探索接受血液透析的ESRD患者的自发脑活动。本研究纳入了19例接受定期血液透析的ESRD患者。选取18名年龄、性别和教育水平相匹配的志愿者作为健康对照组。所有参与者均进行了静息态功能磁共振成像扫描、神经心理学测试和实验室检测。ALFF用于评估脑内固有活动。采用独立样本t检验来获取组间差异。应用Spearman相关分析来评估ALFF变化、神经心理学指标和临床指标之间的关联。与健康对照组相比，血液透析患者在楔前叶、右侧角回/下小叶的ALFF降低，而在左侧海马旁回/海马和右侧中央前回/中央后回的ALFF升高。这些区域的ALFF异常与血红蛋白水平密切相关。此外，左侧海马旁回/海马的ALFF升高与长时延迟自由回忆得分呈负相关。血液透析患者在默认模式网络（DMN）区域存在异常的ALFF，尤其是在楔前叶和海马旁回/海马，这可能与血液透析相关的神经病理机制有关。
