Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital of Sichuan University, Chengdu, PR China.
Department of MR, First Affiliated Hospital of Xinxiang Medical University, Weihui, PR China.
J Neurosci Res. 2020 Dec;98(12):2566-2578. doi: 10.1002/jnr.24725. Epub 2020 Sep 15.
Patterns of change in whole-brain functional networks remain poorly understood in patients with end-stage renal disease (ESRD) undergoing hemodialysis (HD). We conducted a prospective research to investigate the topological properties of whole-brain functional networks in those patients using a graph-based network analysis. Resting-state functional magnetic resonance imaging was performed on 51 ESRD patients (25 HD and 26 nondialysis patients) and 36 healthy controls (HCs). We compared the topological properties of brain functional networks among the three groups, and analyzed the relationships between those significant parameters and clinical variables in ESRD patients. Progressively disrupted global topological organizations were observed from nondialysis patients to HD patients compared with HCs (all p < 0.05 after Bonferroni correction). HD patients, relative to HCs, showed significantly decreased nodal centralities in the left temporal pole: superior temporal gyrus, bilateral median cingulate and paracingulate gyri, bilateral hippocampus, bilateral parahippocampal gyrus, and bilateral amygdala, and showed increased nodal centralities in the orbital part of the bilateral middle frontal gyrus, left cuneus, and left superior occipital gyrus (all p < 0.05 after Bonferroni correction). Furthermore, nodal centralities in the bilateral hippocampus were significantly decreased in HD patients compared with nondialysis patients (p < 0.05 after Bonferroni correction). Dialysis duration negatively correlated with global efficiency in ESRD patients undergoing HD (r = -0.676, FDR q = 0.004). This study indicates that ESRD patients exhibit disruptions in brain functional networks, which are more severe in HD patients, and these alterations are correlated with cognitive performance and clinical markers.
在接受血液透析 (HD) 的终末期肾病 (ESRD) 患者中,全脑功能网络的变化模式仍知之甚少。我们进行了一项前瞻性研究,使用基于图的网络分析来研究这些患者全脑功能网络的拓扑性质。对 51 名 ESRD 患者(25 名血液透析患者和 26 名非透析患者)和 36 名健康对照者(HCs)进行了静息态功能磁共振成像。我们比较了三组脑功能网络的拓扑性质,并分析了 ESRD 患者这些显著参数与临床变量之间的关系。与 HCs 相比,从非透析患者到 HD 患者,观察到全脑拓扑组织逐渐破坏(所有 Bonferroni 校正后 p < 0.05)。与 HCs 相比,HD 患者的左侧颞极:颞上回、双侧中央前回和旁中央回、双侧海马、双侧海马旁回和双侧杏仁核的节点中心度显著降低,双侧额中回眶部、左侧楔叶和左侧顶叶上回的节点中心度显著升高(所有 Bonferroni 校正后 p < 0.05)。此外,与非透析患者相比,HD 患者双侧海马的节点中心度显著降低(Bonferroni 校正后 p < 0.05)。HD 患者的透析时间与全球效率呈负相关(r = -0.676,FDR q = 0.004)。这项研究表明,ESRD 患者的脑功能网络存在紊乱,HD 患者的紊乱更为严重,这些改变与认知表现和临床标志物相关。