Department of Radiology, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dis, Haikou, Hainan, P. R. China.
Department of Ultrasound, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), No. 19, Xiuhua St, Xiuying Dis, Haikou, Hainan, P. R. China.
Nephrol Dial Transplant. 2023 Mar 31;38(4):992-1001. doi: 10.1093/ndt/gfac263.
Hippocampal alterations have been implicated in the pathophysiology of cognitive impairment in hemodialysis patients. The hippocampus consists of several distinct subfields, and the molecular mechanisms underlying cognition might be associated with specific hippocampal subfield volume changes. However, this has not yet been investigated in hemodialysis patients. This study aimed to explore volumetric abnormalities in hippocampal subfields in regular hemodialysis patients.
High-resolution T1-weighted structural images were collected in 61 subjects including 36 hemodialysis patients and 25 healthy controls. A state-of-the-art hippocampal segmentation approach was adopted to segment the hippocampal subfields. Group differences in hippocampal subfield volumes were assessed in Python with a statsmodels module using an ordinary least squares regression with age and sex as nuisance effects.
Hemodialysis patients had significantly smaller volumes in the bilateral hippocampus (P < .05/2, Bonferroni corrected), cornu ammonis 1 (CA1), CA4, granule cell and molecular layer of the dentate gyrus, hippocampus-amygdala transition area and molecular layer of the hippocampus than healthy controls (P < .05/24, Bonferroni corrected). Hemodialysis patients also had lower volumes in the left hippocampal tail and right fimbria than healthy controls (P < .05/24, Bonferroni corrected). Hippocampal subfield volumes were associated with neuropsychological test scores, the duration of disease and hemoglobin levels.
We found smaller hippocampal subfield volumes in hemodialysis patients, which were associated with impaired cognition, supporting their role in memory disturbance in the hemodialysis population. However, multiple clinical factors may have confounded the results, and therefore, the interpretation of these results needs to be cautious.
海马体的改变与血液透析患者认知障碍的病理生理学有关。海马体由几个不同的亚区组成，认知的分子机制可能与特定海马体亚区体积的变化有关。然而，这在血液透析患者中尚未得到研究。本研究旨在探讨常规血液透析患者海马亚区的体积异常。
在 61 名受试者中采集了高分辨率 T1 加权结构图像，包括 36 名血液透析患者和 25 名健康对照者。采用一种最先进的海马分割方法对海马亚区进行分割。使用 statsmodels 模块中的普通最小二乘回归，以年龄和性别为混杂因素，在 Python 中评估海马亚区体积的组间差异。
与健康对照组相比，血液透析患者双侧海马体（P <.05/2，Bonferroni 校正）、角回 1 区（CA1）、CA4、颗粒细胞和齿状回分子层、海马体-杏仁核过渡区和海马体分子层的体积明显较小（P <.05/24，Bonferroni 校正）。血液透析患者左侧海马体尾部和右侧穹窿的体积也小于健康对照组（P <.05/24，Bonferroni 校正）。海马亚区体积与神经心理学测试评分、疾病持续时间和血红蛋白水平有关。
我们发现血液透析患者的海马体亚区体积较小，与认知障碍有关，支持其在血液透析人群记忆障碍中的作用。然而，多种临床因素可能混淆了结果，因此，对这些结果的解释需要谨慎。
