Department of Radiology, First People's Hospital of Linping District, Hangzhou, China.
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical University, Weihui, China.
Brain Behav. 2023 Jul;13(7):e3057. doi: 10.1002/brb3.3057. Epub 2023 May 15.
Previous studies have revealed abnormal resting-state brain activity in patients with end-stage renal disease (ESRD); however, the results are inconsistent. Thus, we conducted a coordinate-based meta-analysis of whole-brain resting-state functional neuroimaging studies in ESRD to identify the most consistent neural activity alterations in ESRD patients and explore their relation to serological indicators.
A comprehensive literature search strategy was applied to select pertinent studies up to December 2022 in PubMed, Web of Science, and Embase databases. Voxel-wise meta-analysis was conducted via the latest meta-analytic algorithm, seed-based d mapping with permutation of subject images software. Meta-regression analyses were also conducted to explore the potential effect of clinical variables on resting-state neural activity.
Eleven studies comprising 304 patients with ESRD and 296 healthy controls (HCs) were included. Compared with HCs, ESRD patients showed decreased brain activity in the default mode network (DMN) regions, including the bilateral anterior cingulate cortex/medial prefrontal cortex, bilateral midcingulate cortex/posterior cingulate cortex, bilateral precuneus, and right angular gyrus. The neural activities in the bilateral midcingulate cortex, bilateral midcingulate cortex/posterior cingulate cortex, and right angular gyrus were significantly associated with serological indexes including hemoglobin, urea, and creatinine levels.
The present study provides a quantitative overview of brain activity alterations in patients with ESRD, and the results confirm the essential role of the DMN in ESRD patients, which may be the potential neural basis of their cognitive deficits. Additionally, some serological indicators may be used as predictive markers for progressive impairment of brain function.
先前的研究表明，终末期肾病（ESRD）患者存在静息态大脑活动异常；然而，结果并不一致。因此，我们对 ESRD 的全脑静息态功能神经影像学研究进行了基于坐标的荟萃分析，以确定 ESRD 患者最一致的神经活动改变，并探讨其与血清学指标的关系。
我们应用全面的文献检索策略，在 PubMed、Web of Science 和 Embase 数据库中选择截至 2022 年 12 月的相关研究。通过最新的荟萃分析算法，即基于种子的 d 映射与受试者图像置换软件，进行体素级别的荟萃分析。还进行了荟萃回归分析，以探索静息态神经活动的潜在临床变量影响。
纳入了 11 项研究，包括 304 名 ESRD 患者和 296 名健康对照者（HCs）。与 HCs 相比，ESRD 患者的默认模式网络（DMN）区域的大脑活动减少，包括双侧前扣带回/内侧前额叶皮质、双侧中央旁小叶/后扣带回、双侧楔前叶和右侧角回。双侧中央旁小叶、双侧中央旁小叶/后扣带回和右侧角回的神经活动与血红蛋白、尿素和肌酐水平等血清学指标显著相关。
本研究提供了 ESRD 患者大脑活动改变的定量概述，结果证实了 DMN 在 ESRD 患者中的重要作用，这可能是他们认知缺陷的潜在神经基础。此外，一些血清学指标可用作预测脑功能进行性损害的标志物。
