Abstract
Cognitive impairment is prevalent in hemodialysis end-stage renal disease (ESRD) patients. It might be associated with poor prognosis. Nevertheless, the underlying mechanisms have not been completely clarified. This study explored spontaneous brain activity in ESRD patients on hemodialysis by using the amplitude of low-frequency fluctuation (ALFF). Nineteen ESRD patients on regular hemodialysis were included in this study. Eighteen age-, sex- and education level-matched volunteers were enrolled as the healthy control group. All participants had resting-state functional MRI scanning, neuropsychological tests, and laboratory testing. ALFF was used for assessing intrinsic brain activity. Independent samples t-test was used for obtaining group differences. Spearman correlation analysis was applied to assess the association between ALFF changes, neuropsychological, and clinical indices. Compared to the healthy control group, hemodialysis patients showed decreased ALFF in the precuneus, right angular gyrus/inferior lobule as well as increased ALFF in the left parahippocampus/hippocampus and right precentral/postcentral gyrus. The ALFF abnormalities in these regions were closely associated with hemoglobin levels. Also, increased ALFF in the left parahippocampus/hippocampus showed a negative correlation with the score of long-delayed free recall. Hemodialysis patients had aberrant ALFF in the default mode network (DMN) regions, particularly in the precuneus and parahippocampus/hippocampus, which may be correlated with neuropathological mechanisms involved in hemodialysis.
Highlights
Cognitive dysfunction commonly occurred in patients with end-stage renal disease (ESRD; Murray et al, 2006; Drew et al, 2017)
This study revealed abnormal amplitude of low-frequency fluctuation (ALFF) in some default mode network (DMN) regions in hemodialysis patients
The hemodialysis group displayed decreased spontaneous brain activity in the precuneus/cuneus and angular gyrus, but increased activity in the parahippocampus/hippocampus compared with healthy controls (HC), which is associated with neuropsychological and clinical indices
Summary
Cognitive dysfunction commonly occurred in patients with end-stage renal disease (ESRD; Murray et al, 2006; Drew et al, 2017). This is high in those treated with hemodialysis. It is reported that approximately 70% of patients on hemodialysis who are aged no less than 55 years old have moderate to severe cognition dysfunction, which was four times equal to age-matched controls (O’Lone et al, 2016). Cognitive dysfunction includes memory decline, Spontaneous Brain Activity in Hemodialysis Patients attention distraction, and diminished motor ability. Cognitive impairment is independently correlated with lower quality of life, the risk for hospitalization, higher rates of morbidity and mortality (Griva et al, 2010), indicating an urgent need to explore the pathophysiological mechanism of cognition impairments in hemodialysis ESRD patients
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