Abnormal Functional Attributes of Central Executive Network in Patients with Mild Cognitive Impairment Associated with End-Stage Renal Disease

Abstract

Rationale and Objectives

To assess changes in the central executive network (CEN) of patients with mild cognitive impairment (MCI) associated with end-stage renal disease (ESRD).

Methods

A total of 121 patients with ESRD and 66 healthy controls (HCs) were enrolled. Patients were divided into an MCI group (n = 67) and a cognitively unimpaired group (n = 54). All participants underwent resting-state functional magnetic resonance imaging and were evaluated using the Montreal Cognitive Assessment (MoCA). The functional attributes of the CEN were calculated using three methods of functional connectivity (FC) analysis. Relationships among imaging features, cognitive scale scores, and clinical data were assessed, and a model was constructed to diagnose MCI in patients with ESRD.

Results

The comparison of the three groups showed that there were significant differences in the FC values of five connection pairs within the CEN, and the CEN demonstrated significant differences in connectivity to ten brain regions. In patients with MCI associated with ESRD, the information transmission efficiency of the CEN was reduced, which demonstrates the characteristics of a random network to some extent. Significant correlations were observed among imaging parameters, cognitive scale scores, and clinical data. The diagnostic model constructed based on these results demonstrated excellent discrimination and calibration.

Conclusion

Alterations in the function of the CEN provide relevant bases for revealing the neuropathological mechanism of MCI in patients with ESRD. The diagnostic model developed in this study may help to establish more reliable imaging markers for detecting early cognitive impairment in this patient population.