Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
Department of Medical Imaging, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Metab Brain Dis. 2023 Dec;38(8):2817-2829. doi: 10.1007/s11011-023-01293-5. Epub 2023 Sep 30.
End-stage kidney disease and mild cognitive impairment (ESKD-MCI) affect the quality of life and long-term treatment outcomes of patients affected by these diseases. Clarifying the morphological changes from brain injuries in ESKD-MCI and their relationship with clinical features is helpful for the early identification and intervention of MCI before it progresses to irreversible dementia. This study gathered data from 23 patients with ESKD-MCI, 24 patients with ESKD and non-cognitive impairment (NCI), and 27 health controls (HCs). Structural magnetic resonance studies, cognitive assessments, and general clinical data were collected from all participants. Voxel-based morphometry analysis was performed to compare grey matter (GM) volume differences between the groups. The patients' GM maps and clinical features were subjected to univariate regression to check for possible correlations. Patients with ESKD-MCI displayed significantly more impairments in multiple cognitive domains, including global cognition, visuospatial and executive function, and memory, compared to patients with ESKD-NCI. Using a more liberal threshold (P < 0.001, uncorrected), we found that compared to patients with ESKD-NCI, patients with ESKD-MCI exhibited clusters of regions with lower GM volumes, including the right hippocampus (HIP), parahippocampal gyrus (PHG), Rolandic operculum, and supramarginal gyrus. The volumes of the right HIP and PHG were negatively correlated with serum calcium levels. ESKD-MCI was associated with a subtle volume reduction of GM in several brain areas known to be involved in memory, language, and auditory information processing. We speculate that these slight morphometric impairments may be associated with disturbed calcium metabolism.
终末期肾病和轻度认知障碍（ESKD-MCI）影响受这些疾病影响的患者的生活质量和长期治疗结果。阐明 ESKD-MCI 中脑损伤的形态变化及其与临床特征的关系，有助于在 MCI 进展为不可逆痴呆之前对其进行早期识别和干预。本研究收集了 23 例 ESKD-MCI 患者、24 例 ESKD 非认知障碍（NCI）患者和 27 例健康对照（HCs）的数据。对所有参与者进行了结构磁共振研究、认知评估和一般临床数据收集。对灰质（GM）体积差异进行基于体素的形态学分析。将患者的 GM 图谱和临床特征进行单变量回归，以检查可能的相关性。与 ESKD-NCI 患者相比，ESKD-MCI 患者在多个认知领域（包括整体认知、视空间和执行功能以及记忆）表现出更明显的损伤。使用更宽松的阈值（P < 0.001，未校正），我们发现与 ESKD-NCI 患者相比，ESKD-MCI 患者存在多个 GM 体积较低的区域簇，包括右侧海马（HIP）、海马旁回（PHG）、 Rolandic 脑岛盖和缘上回。右侧 HIP 和 PHG 的体积与血清钙水平呈负相关。ESKD-MCI 与几个已知参与记忆、语言和听觉信息处理的脑区的 GM 体积轻微减少有关。我们推测这些形态学损伤可能与钙代谢紊乱有关。
