Peng Cong, Ran Qian, Liu Cheng Xuan, Zhang Ling, Yang Hua
Department of Radiology, Chongqing Hospital of Traditional Chinese Medicine, Chongqing, China.
Department of Radiology, Xinqiao Hospital, Chongqing, China.
Front Hum Neurosci. 2022 Aug 23;16:967214. doi: 10.3389/fnhum.2022.967214. eCollection 2022.
To investigate the instant impact of hemodialysis (HD) on the cerebral morphological measurements of patients with end-stage renal disease (ESRD).
Twenty-five patients undergoing maintenance HD and twenty-eight age-, sex-, and education-matched healthy control (HC) were included. The HD group and HC group had 3D high-resolution structural magnetic resonance imaging (MRI) scans twice and once, respectively. Both groups underwent neuropsychologic tests. The morphological measurements of structural MRI were measured using CAT12 and these measures were compared among three groups. The relationship between morphological measures and clinical parameters and neuropsychological tests were investigated through multiple regression analysis.
Compared to the HC group, the cortical thickness before HD significantly decreased in the bilateral temporal lobe and significantly decreased in the left superior temporal gyrus after HD. The cortical thickness significantly increased in the bilateral temporal lobe, frontal lobe and occipital lobe after HD compared to before HD. The sulcus depth in the bilateral insula, frontal lobe, and parietal lobe after HD significantly increased compared to before HD. No significant differences in sulcus depth between HD and HC were detected. After HD, the cortical thickness of the right parsopercularis was positively correlated with the number connection test-A. Cortical thickness in multiple regions were positively correlated with blood flow velocity and cortical thickness in the left parahippocampal gyrus was negatively correlated with ultrafiltration volume. Patients showed better performance in the digit symbol test and line tracing test after HD compared to before HD, but there were no significant differences in the comparison of neuropsychologic tests between patients and HC.
The instant morphological changes were captured during a single hemodialysis in HD patients. There was an association between these instant changes in the brain and clinical parameters and neuropsychologic tests. This work implied the instant impact of a single hemodialysis impact on the brain in HD patients.
探讨血液透析（HD）对终末期肾病（ESRD）患者脑形态学测量的即时影响。
纳入25例接受维持性HD的患者以及28例年龄、性别和教育程度相匹配的健康对照（HC）。HD组和HC组分别进行了2次和1次三维高分辨率结构磁共振成像（MRI）扫描。两组均接受神经心理学测试。使用CAT12测量结构MRI的形态学指标，并在三组之间进行比较。通过多元回归分析研究形态学指标与临床参数及神经心理学测试之间的关系。
与HC组相比，HD前双侧颞叶皮质厚度显著降低，HD后左侧颞上回皮质厚度显著降低。与HD前相比，HD后双侧颞叶、额叶和枕叶皮质厚度显著增加。HD后双侧岛叶、额叶和顶叶的脑沟深度较HD前显著增加。未检测到HD组和HC组在脑沟深度上的显著差异。HD后，右侧 opercular部皮质厚度与数字连接试验-A呈正相关。多个区域的皮质厚度与血流速度呈正相关，左侧海马旁回皮质厚度与超滤量呈负相关。与HD前相比，患者在HD后数字符号试验和连线试验中的表现更好，但患者与HC在神经心理学测试比较中无显著差异。
在HD患者单次血液透析过程中捕捉到了即时形态学变化。这些脑内即时变化与临床参数及神经心理学测试之间存在关联。这项研究揭示了单次血液透析对HD患者脑的即时影响。
