Ma Chi, Jiang Xinghai, Ren Yande, Gu Gaojie, Fu Airong, Wang Chengjian, Bai Peirui, Zhou Tong, Qin Shanshan, Fu Shengli
Department of Radiology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
Center for Disease Control and Prevention, West Coast New District, Qingdao, Shandong, China.
Brain Imaging Behav. 2022 Jun;16(3):1314-1323. doi: 10.1007/s11682-021-00604-7. Epub 2022 Jan 9.
Abnormal brain structural connectivity of end-stage renal disease(ESRD) is associated with cognitive impairment. However, the characteristics of cortical structural connectivity have not been investigated in ESRD patients. Here, we study structural connectivity of the entire cerebral cortex using a fiber connectivity density(FiCD) mapping method derived from diffusion tensor imaging(DTI) data of 25 ESRD patients and 20 healthy controls, and between-group differences were compared in a vertexwise manner. We also investigated the associations between these abnormal cortical connectivities and the clinical variables using Pearson correlation analysis and multifactor linear regression analysis. Our results demonstrated that the mean global FiCD value was significantly decreased in ESRD patients. Notably, FiCD values were significantly changed(decreased or increased) in certain cortical regions, which mainly involved the bilateral dorsolateral prefrontal cortex(DLPFC), inferior parietal cortex, lateral temporal cortex and middle occipital cortex. In ESRD patients, we found a trend of negative correlation between the increased FiCD values of bilateral middle frontal gyrus and serum creatinine, urea, parathyroid hormone(PTH) levels and dialysis duration. Only the white matter hyperintensity(WMH) scores were significantly negatively correlated with the global FiCD value in multifactor regression analysis. Our results suggested that ESRD patients exhibited extensive impaired cortical structural connectivity, which was related to the severity of WMHs. A compensation mechanism of cortical structural recombination may play a role in how the brain adapts to maintain optimal network function. Additionally, the serum creatinine, urea and PTH levels may be risk factors for brain structural network decompensation in ESRD patients.
终末期肾病（ESRD）患者大脑结构连接异常与认知障碍相关。然而，尚未对ESRD患者的皮质结构连接特征进行研究。在此，我们使用基于25例ESRD患者和20名健康对照者的扩散张量成像（DTI）数据得出的纤维连接密度（FiCD）映射方法，研究了整个大脑皮质的结构连接，并以逐顶点方式比较了组间差异。我们还使用Pearson相关分析和多因素线性回归分析，研究了这些异常皮质连接与临床变量之间的关联。我们的结果表明，ESRD患者的平均全脑FiCD值显著降低。值得注意的是，某些皮质区域的FiCD值发生了显著变化（降低或升高），主要涉及双侧背外侧前额叶皮质（DLPFC）、顶下皮质、颞叶外侧皮质和枕叶中部皮质。在ESRD患者中，我们发现双侧额中回FiCD值升高与血清肌酐、尿素、甲状旁腺激素（PTH）水平及透析时间之间存在负相关趋势。在多因素回归分析中，只有白质高信号（WMH）评分与全脑FiCD值显著负相关。我们的结果表明，ESRD患者存在广泛的皮质结构连接受损，这与WMH的严重程度有关。皮质结构重组的补偿机制可能在大脑如何适应以维持最佳网络功能中发挥作用。此外，血清肌酐、尿素和PTH水平可能是ESRD患者脑结构网络失代偿的危险因素。
