Department of Internal Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan, 48108, South Korea.
Sci Rep. 2023 Nov 16;13(1):20064. doi: 10.1038/s41598-023-47533-7.
This study aimed to determine whether white matter tracts correlate with kidney function using correlation tractography, and to investigate the effects of dialysis on white matter tracts in patients with end-stage renal disease (ESRD) using differential tractography. Ten patients with ESRD, who had a glomerular filtration rate of < 15 mL/min/1.73 m, were enrolled in this prospective study. Diffusion tensor imaging (DTI) was performed both before and after dialysis. We discovered that white matter tracts correlated with the estimated glomerular filtration rate based on pre- and post-dialysis DTI using correlation tractography and investigated the differences in the white matter tracts between pre- and post-dialysis DTI in patients with ESRD using differential tractography. Correlation tractography revealed no quantitative anisotropy of the white matter tracts that correlated with the estimated glomerular filtration rate in pre- and post-dialysis patients with ESRD. Differential tractography revealed significant differences in several white matter tracts, particularly the cingulum, thalamic radiation, corpus callosum, and superior longitudinal fasciculus, between pre- and post-dialysis DTI, which revealed increased diffusion density after dialysis. We demonstrated the significant effects of dialysis on several white matter tracts in patients with ESRD using differential tractography, which showed increased diffusion density after dialysis. In this study, we confirmed the effects of dialysis on brain structure, especially white matter tracts.
本研究旨在通过相关轨迹追踪法确定脑白质束与肾功能之间的相关性，并通过差异轨迹追踪法研究透析对终末期肾病（ESRD）患者脑白质束的影响。本前瞻性研究纳入了 10 名肾小球滤过率（GFR）<15ml/min/1.73m2 的 ESRD 患者。在透析前后进行弥散张量成像（DTI）。我们发现，使用相关轨迹追踪法，基于透析前后 DTI 的估计肾小球滤过率（eGFR）与脑白质束之间存在相关性，并且使用差异轨迹追踪法，在 ESRD 患者的透析前后 DTI 之间，脑白质束存在差异。相关轨迹追踪法显示，在透析前后的 eGFR 患者中，没有与脑白质束相关的白质束的定量各向异性。差异轨迹追踪法显示，透析前后 DTI 之间存在几条白质束的显著差异，特别是扣带束、丘脑辐射、胼胝体和上纵束，在透析后扩散密度增加。我们使用差异轨迹追踪法显示，透析对 ESRD 患者的几条白质束有显著影响，透析后扩散密度增加。在这项研究中，我们证实了透析对脑结构，特别是脑白质束的影响。
