Abstract
Objective To investigate the changes of brain functions in hemodialysis (HD) patients with end-stage renal disease (ESRD) using resting-state functional magnetic resonance imaging (rs-fMRI) with amplitude of low frequency fluctuation (ALFF)algorithm.Methods Sixty-four HD-ESRD patients and forty-five sex and age-matched healthy controls were included in the rs-fMRI study.All subjects were given neuropsychological tests [number connection type-A (NCT-A) and digit symbol test (DST)] to evaluate cognitive function.Laboratory tests,including serum creatinine and urea,were performed in all HD-ESRD patients.SPM8 and REST1.6 software were used to process the data and to generate all subjects' ALFF maps.One-sample t test was performed to show the spatial pattern of ALFF in each group.Two-sample t test was used to determine the ALFF differences between patients and healthy controls.In addition,Pearson correlation analysis was performed among the ALFF values of significant brain regions and neuropsychological test scores,disease and dialvsis durations,serum creatinine and urea levels.Results Within each group,bilateral precuneus,superior frontal gyrus,middle frontal gyrus,inferior parietal lobule,cuneus and superior temporal gy rus showed higher ALFF values than the global mean ALFF value.Compared with the healthy controls,HD-ESRD patients presented decreased ALFF in bilateral precuneus,frontal lobes,middle temporal gyrus,and right inferior parietal lobule (voxel volumes:270-6 804 mm3,t =-7.41--3.78,all P＜0.01).The DST scores of HD-ESRD patients positively correlated with ALFF values in right middle frontal gyrus (r=0.273,P＜0.05).The disease durations negatively correlated with ALFF values in bilateral precuneus,left supramarginal gyrus and left medial frontal gyrus (r =-0.301,-0.278,-0.298,-0.287,allP＜0.05).The dialysis durations,NCT-A values,serum creatinine and urea levels of HD-ESRD patients showed no significant correlation with ALFF values (all P＞0.05).Conclusions HD-ESRD patients have abnormal ALFF values in several brain areas mainly located in default mode network (DMN),suggesting impaired spontaneous neural activity in HD-ESRD patients,and disease durations might be a risk factor for impaired spontaneous neural activity in HD-ESRD patients. Key words: Nephrosis; Dialysis; Magnetic resonance imaging
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