Abstract
ObjectiveTo prospectively investigate and detect early cerebral regional homogeneity (ReHo) changes in neurologically asymptomatic patients with end stage renal disease (ESRD) using in vivo resting-state functional MR imaging (Rs-fMRI).MethodsWe enrolled 20 patients (15 men, 5 women; meanage, 37.1 years; range, 19–49 years) with ESRD and 20 healthy controls (15 men, 5 women; mean age, 38.3 years; range, 28–49 years). The mean duration of hemodialysis for the patient group was 10.7±6.4 monthes. There was no significant sex or age difference between the ESRD and control groups. Rs-fMRI was performed using a gradient-echo echo-planar imaging sequence. ReHo was calculated using software (DPARSF). Voxel-based analysis of the ReHo maps between ESRD and control groups was performed with a two-samples t test. Statistical maps were set at P value less than 0.05 and were corrected for multiple comparisons. The Mini-Mental State Examination (MMSE) was administered to all participants at imaging.ResultsReHo values were increased in the bilateral superior temporal gyrus and left medial frontal gyrus in the ERSD group compared with controls, but a significantly decreased ReHo value was found in the right middle temporal gyrus. There was no significant correlation between ReHo values and the duration of hemodialysis in the ESRD group. Both the patients and control subjects had normal MMSE scores (≥28).ConclusionsOur finding revealed that abnormal brain activity was distributed mainly in the memory and cognition related cotices in patients with ESRD. The abnormal spontaneous neuronal activity in those areas provide information on the neural mechanisms underlying cognitive impairment in patients with ESRD, and demonstrate that Rs-fMRI with ReHo analysis is a useful non-invasive imaging tool for the detection of early cerebral ReHo changes in hemodialysis patients with ESRD.
Highlights
End stage renal disease (ESRD) is defined as a glomerular filtration rate (GFR) less than 15 mL/min/1.73 m2, or chronic renal failure that has progressed to the point at which the kidneys are permanently functioning at less than 10% of their capacity
There were no significant differences in age, sex, years of education and number of cigarettes smoked per day between patients with ESRD and control subjects
High regional homogeneity (ReHo) in the right middle temporal gyrus was shown, but this was not found in the patient group
Summary
End stage renal disease (ESRD) is defined as a glomerular filtration rate (GFR) less than 15 mL/min/1.73 m2, or chronic renal failure that has progressed to the point at which the kidneys are permanently functioning at less than 10% of their capacity. Patients with ESRD usually have central nervous system abnormalities, some related to ESRD itself and others related to problems secondary to hemodialysis [1,2,3,4]. These Patients with ESRD often present with neurological complications such as focal white matter lesions, cerebral atrophy, osmotic demyelination syndrome, dialysis encephalopathy, hypertensive encephalopathy, intracranial hemorrhage, infarction, sinus thrombosis, and infection [1,2,3,4]. It is important to elucidate the mechanism of depression and cognitive impairment in Patients with ESRD
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