Abstract
PurposeThis study aimed to investigate the topological organization of intrinsic functional brain networks in patients with end-stage renal disease (ESRD).Materials and MethodsResting-state functional MRI data were collected from 22 patients with ESRD (16 men, 18–61 years) and 29age- and gender-matched healthy controls (HCs, 19 men, 32–61 years). Whole-brain functional networks were obtained by calculating the interregional correlation of low-frequency fluctuations in spontaneous brain activity among 1,024 parcels that cover the entire cerebrum. Weighted graph-based models were then employed to topologically characterize these networks at different global, modular and nodal levels.ResultsCompared to HCs, the patients exhibited significant disruption in parallel information processing over the whole networks (P< 0.05). The disruption was present in all the functional modules (default mode, executive control, sensorimotor and visual networks) although decreased functional connectivity was observed only within the default mode network. Regional analysis showed that the disease disproportionately weakened nodal efficiency of the default mode components and tended to preferentially affect central or hub-like regions. Intriguingly, the network abnormalities correlated with biochemical hemoglobin and serum calcium levels in the patients. Finally, the functional changes were substantively unchanged after correcting for gray matter atrophy in the patients.ConclusionOur findings provide evidence for the disconnection nature of ESRD’s brain and therefore have important implications for understanding the neuropathologic substrate of the disease from disrupted network organization perspective.
Highlights
The human brain operates essentially as an interconnected network that underscores cognition and behavior [1,2]
There were no significant differences in gender (P = 0.583), age (P = 0.127) or education level (P = 0.245) between the End-stage renal disease (ESRD) and healthy controls (HC) groups
Lower blood systolic pressure and diastolic pressure were observed in the patients compared with the HCs.The mean duration of hemodialysis for the patients was 7.4±2.2 months
Summary
The human brain operates essentially as an interconnected network that underscores cognition and behavior [1,2]. Accumulating evidence indicates that disturbances in these configurations are largely responsible for cognitive and behavior dysfunction in various brain disorders [7,8], hastening conceptual onset of pathoconnectomics [9], the mapping of abnormal brain networks under pathological conditions. End-stage renal disease (ESRD) is a disease characterized by multi-organ dysfunction. It typically occurs when chronic renal failure progresses to a point where the kidneys are permanently functioning at less than 10% of their capacity [10]. Understanding brain abnormalities in neurologically asymptomatic patients with ESRD is crucially important for the early diagnosis, prognosis improvement and ultimate, reduction of death rate
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