Wang Di, Li Wenqing, Tang Yushang, Zhang Wanfen, Liu Tongqiang, Shi Haifeng
Department of Nephrology, The Second People's Hospital of Changzhou, The Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China.
Graduate College, Dalian Medical University, Dalian, China.
BMC Neurol. 2024 Dec 19;24(1):486. doi: 10.1186/s12883-024-03985-6.
Through resting state functional magnetic resonance imaging (rs-fMRI) we evaluate the spontaneous brain activity changes of maintenance hemodialysis (MHD) patients with restless legs syndrome (RSL) and analyzed the imaging features and related mechanisms of RLS in patients with MHD.
We select 27 MHD patients with RLS and 27 patients without RSL matched by age, gender, cognitive function. Both groups underwent neuropsychological tests and MRI scans. MRI data analysis was performed to obtain and compare the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) values, which were mALFF, mfALFF, and mReHo. Clinical data were collected and compared. Differentiated indicators and RLS scores conduct Pearson correlation analysis.
Compared with the MHD-nRLS group, the MHD-RLS group showed significantly lower mALFF values in the left precentral, right precentral gyrus, and right postcentral gyrus, lower mfALFF values in the left precentral gyrus, right precentral gyrus, left calcarine fissure, left lingual gyrus, left postcentral gyrus, and right postcentral gyrus, and lower mReHo values in the left precentral gyrus, right precentral gyrus, left calcarine fissure, left lingual gyrus, left postcentral gyrus, and right postcentral gyrus, and right postcentral gyrus (P < 0.05). The MHD-RLS group exhibited lower hemoglobin levels (P = 0.001), higher total iron-binding capacity levels (P = 0.011), and higher folic acid levels (P = 0.022). The above indicators were correlated with RLS scores using Pearson correlation analysis, and it was found that the mfALFF value of the right precentral gyrus and the right postcentral gyrus, and the mReHo values of the right precentral gyrus and right postcentral gyrus were negatively correlated with the RLS score (r = -0.567, P = 0.002;r = -0.705, P < 0.001;r = -0.414, P = 0.032; r = -0.410, P = 0.034), and the hemoglobin concentration was negatively correlated with the RLS scores (r = -0.394, P = 0.042).
Patients with MHD-RLS exhibit abnormal spontaneous brain activity in the right precentral gyrus and right postcentral gyrus within the sensorimotor network, along with lower hemoglobin levels, which may be associated with the pathogenesis and severity of MHD-RLS.
通过静息态功能磁共振成像（rs-fMRI）评估伴有不安腿综合征（RLS）的维持性血液透析（MHD）患者的自发性脑活动变化，并分析MHD患者中RLS的影像学特征及相关机制。
我们选取了27例伴有RLS的MHD患者以及27例年龄、性别、认知功能相匹配的无RLS的患者。两组均接受神经心理学测试和MRI扫描。进行MRI数据分析以获取并比较低频波动幅度（ALFF）、低频波动分数幅度（fALFF）和局部一致性（ReHo）值，即mALFF、mfALFF和mReHo。收集并比较临床数据。对鉴别指标和RLS评分进行Pearson相关性分析。
与MHD-nRLS组相比，MHD-RLS组在左侧中央前回、右侧中央前回和右侧中央后回的mALFF值显著更低，在左侧中央前回、右侧中央前回、左侧距状裂、左侧舌回、左侧中央后回和右侧中央后回的mfALFF值更低，在左侧中央前回、右侧中央前回、左侧距状裂、左侧舌回、左侧中央后回和右侧中央后回以及右侧中央后回的mReHo值更低（P<0.05）。MHD-RLS组的血红蛋白水平更低（P=0.001），总铁结合力水平更高（P=0.011），叶酸水平更高（P=0.022）。使用Pearson相关性分析将上述指标与RLS评分相关联，发现右侧中央前回和右侧中央后回的mfALFF值以及右侧中央前回和右侧中央后回的mReHo值与RLS评分呈负相关（r=-0.567，P=0.002；r=-0.705，P<0.001；r=-0.414，P=0.032；r=-0.410，P=0.034），血红蛋白浓度与RLS评分呈负相关（r=-0.394，P=0.042）。
MHD-RLS患者在感觉运动网络内的右侧中央前回和右侧中央后回表现出自发性脑活动异常，同时血红蛋白水平较低，这可能与MHD-RLS的发病机制和严重程度相关。
