Department of Radiology, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China.
Department of Nephrology, The First Affiliated Hospital of Anhui Medical University, Hefei, P.R. China.
Ren Fail. 2023 Dec;45(1):2238829. doi: 10.1080/0886022X.2023.2238829.
End-stage renal disease (ESRD) patients have functional and structural brain abnormalities. The cerebellum also showed varying degrees of damage. However, no studies on cerebellar-cerebral functional connectivity (FC) have been conducted in ESRD patients. This study aimed to investigate the changes in cerebellar-cerebral FC in ESRD patients and its relationship with neuropsychological and clinical indexes.
Resting-state functional magnetic resonance imaging and neuropsychological assessment were performed on 37 ESRD patients and 35 control subjects. Seed-based FC analysis was performed to investigate inter-group differences in cerebellar-cerebral FC. In addition, the relations of altered FC with the neuropsychological function and clinical indicators were analyzed in ERSD patients.
ESRD patients exhibited alterations in cerebellar-cerebral FC involving the executive control network, default mode network, and affective-limbic network compared to control subjects (False discovery rate-corrected, < 0.05). The altered cerebellar-cerebral FC was associated with the Montreal Cognitive Assessment Scale score ( < 0.05), and correlated with serum creatinine and uric acid levels within the ESRD group ( < 0.05).
The study indicates that cerebellar-cerebral FC is involved in the neural substrates of cognitive impairment in ESRD patients. The findings may provide clinically relevant new neuroimaging biomarkers for the neuropathological mechanisms underlying cognitive impairment of ESRD.
终末期肾病（ESRD）患者存在功能和结构脑异常。小脑也表现出不同程度的损伤。然而，尚未对 ESRD 患者的小脑-大脑功能连接（FC）进行研究。本研究旨在探讨 ESRD 患者小脑-大脑 FC 的变化及其与神经心理学和临床指标的关系。
对 37 例 ESRD 患者和 35 例对照进行静息态功能磁共振成像和神经心理学评估。采用基于种子的 FC 分析来研究小脑-大脑 FC 的组间差异。此外，还分析了 ESRD 患者改变的 FC 与神经心理学功能和临床指标的关系。
与对照组相比，ESRD 患者的小脑-大脑 FC 发生改变，涉及执行控制网络、默认模式网络和情感边缘网络（False discovery rate-corrected，<0.05）。改变的小脑-大脑 FC 与蒙特利尔认知评估量表评分相关（<0.05），并与 ESRD 组内的血清肌酐和尿酸水平相关（<0.05）。
本研究表明小脑-大脑 FC 参与了 ESRD 患者认知障碍的神经基础。这些发现可能为 ESRD 认知障碍的神经病理学机制提供有临床意义的新的神经影像学生物标志物。
