Effect of Dialysis on Structural Brain Connectivity in Patients with End-Stage Renal Disease.

IF 2.2 3区医学 Q3 HEMATOLOGY Blood Purification Pub Date : 2024-09-05 DOI:10.1159/000541239

Byeongo Choi, Chang Min Heo, Jiyae Yi, Dong Ah Lee, Yoo Jin Lee, Sihyung Park, Yang Wook Kim, Junghae Ko, Bong Soo Park, Kang Min Park

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Abstract

Introduction: Patients with end-stage renal disease (ESRD) are known to have reduced structural and functional brain connectivity in the brain regions associated with cognitive function. However, the effect of dialysis on brain connectivity remains unclear. This study aimed to evaluate the effects of dialysis on structural brain connectivity in patients with ESRD.

Methods: This prospective study included 20 patients with ESRD in the pre-dialysis stage and 35 healthy controls. The patients underwent T2-weighted and three-dimensional T1-weighted magnetic resonance imaging before and 3 months after dialysis initiation. Moreover, the cortical thickness was calculated. We applied graph theoretical analysis to calculate the structural covariance network based on cortical thickness. We compared the cortical thickness and structural covariance network of patients with ESRD in the pre-dialysis stage with those of healthy controls and with those of patients with ESRD in the post-dialysis stage.

Results: The mean cortical thickness in both hemispheres was lower in patients with ESRD in the pre-dialysis stage than in healthy controls (2.296 vs. 2.354, p = 0.030; 2.282 vs. 2.362, p = 0.004, respectively) and was higher in patients with ESRD in the post-dialysis stage than in those in the pre-dialysis stage (2.333 vs. 2.296, p = 0.001; 2.322 vs. 2.282, p = 0.002, respectively). Analysis of the structural covariance network revealed that the assortative coefficient was lower in patients with ESRD in the pre-dialysis stage than in healthy controls (-0.062 vs. -0.031, p = 0.029) and was higher in patients with ESRD in the post-dialysis stage than in those in the pre-dialysis stage (-0.002 vs. -0.062, p = 0.042).

Conclusion: We observed differences in the cortical thickness and structural covariance networks before and after dialysis in patients with ESRD. This indicates that dialysis affects structural brain connectivity, contributing to the understanding of the pathophysiological mechanism of cognitive function alterations resulting from dialysis in patients with ESRD.

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透析对终末期肾病患者大脑结构连通性的影响。

简介众所周知，终末期肾病（ESRD）患者与认知功能相关的脑区的结构和功能性脑连接性降低。然而，透析对大脑连接性的影响仍不清楚。本研究旨在评估透析对 ESRD 患者大脑结构连通性的影响：这项前瞻性研究纳入了 20 名处于透析前期的 ESRD 患者和 35 名健康对照者。患者在开始透析前和透析后 3 个月分别接受了 T2 加权和三维 T1 加权磁共振成像检查。此外，我们还计算了皮质厚度。我们应用图论分析计算了基于皮质厚度的结构协方差网络。我们比较了透析前阶段 ESRD 患者与健康对照组以及透析后阶段 ESRD 患者的皮质厚度和结构协方差网络：透析前ESRD患者两个半球的平均皮质厚度低于健康对照组（分别为2.296 vs. 2.354，p=0.030；2.282 vs. 2.362，p=0.004），而透析后ESRD患者两个半球的平均皮质厚度高于透析前ESRD患者（分别为2.333 vs. 2.296，p=0.001；2.322 vs. 2.282，p=0.002）。结构协方差网络分析显示，透析前阶段的ESRD患者的同位系数低于健康对照组（-0.062 vs. -0.031，p=0.029），透析后阶段的ESRD患者的同位系数高于透析前阶段的患者（-0.002 vs. -0.062，p=0.042）：我们观察到透析前后 ESRD 患者大脑皮层厚度和结构协方差网络的差异。结论：我们观察到透析前后 ESRD 患者大脑皮层厚度和结构协方差网络的差异，这表明透析会影响大脑结构连通性，有助于了解 ESRD 患者透析导致认知功能改变的病理生理机制。.

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来源期刊

Blood Purification 医学-泌尿学与肾脏学

CiteScore

5.80

自引率

3.30%

发文量

审稿时长

6-12 weeks

期刊介绍： Practical information on hemodialysis, hemofiltration, peritoneal dialysis and apheresis is featured in this journal. Recognizing the critical importance of equipment and procedures, particular emphasis has been placed on reports, drawn from a wide range of fields, describing technical advances and improvements in methodology. Papers reflect the search for cost-effective solutions which increase not only patient survival but also patient comfort and disease improvement through prevention or correction of undesirable effects. Advances in vascular access and blood anticoagulation, problems associated with exposure of blood to foreign surfaces and acute-care nephrology, including continuous therapies, also receive attention. Nephrologists, internists, intensivists and hospital staff involved in dialysis, apheresis and immunoadsorption for acute and chronic solid organ failure will find this journal useful and informative. ''Blood Purification'' also serves as a platform for multidisciplinary experiences involving nephrologists, cardiologists and critical care physicians in order to expand the level of interaction between different disciplines and specialities.