{"title":"Abnormal neurovascular coupling exists in patients with peritoneal dialysis and hemodialysis: evidence from a multi-mode MRI study.","authors":"Xiayan Yin, Wenbo Yang, Lijun Song, Jiamin Liu, Mingan Li, Zhenghan Yang, Wenhu Liu, Zhenchang Wang, Hao Wang, Weikang Guo","doi":"10.1093/ckj/sfae353","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Neurovascular coupling (NVC), as indicated by a comprehensive analysis of the amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF), provides mechanistic insights into neurological disorders. Patients undergoing peritoneal dialysis (PD) and hemodialysis (HD) often face cognitive impairment, the causes of which are not fully understood.</p><p><strong>Methods: </strong>ALFF was derived from functional magnetic resonance imaging, and CBF was quantified using arterial spin labeling in a cohort comprising 58 patients with PD, 60 patients with HD and 62 healthy controls. Voxel-based global analysis for both ALFF and CBF, alongside region-based analyses of ALFF-CBF coupling coefficients, were conducted. Additionally, the study explored the correlation between clinical laboratory indices and imaging metrics.</p><p><strong>Results: </strong>Compared with HC, NVC was reduced in the bilateral medial superior frontal gyrus (SFGmed), insula, posterior cingulate cortex (PCC) and caudate (CAU) among dialysis patients. Furthermore, the PD group exhibited lower NVC in the bilateral SFGmed, bilateral PCC and left CAU compared with the HD group. Within the PD group, sodium level was negatively correlated with the ALFF-CBF coupling coefficient in the right insula. Additionally, a positive correlation emerged between the ALFF-CBF coupling coefficient in bilateral SFGmed and the dialysis adequacy.</p><p><strong>Conclusion: </strong>While Montreal Cognitive Assessment scores did not significantly differ between patients with PD and HD, PD group demonstrated poorer NVC in the bilateral SFGmed, bilateral PCC and left CAU. Sodium level and dialysis adequacy may affect NVC in patients with PD.</p>","PeriodicalId":10435,"journal":{"name":"Clinical Kidney Journal","volume":"18 1","pages":"sfae353"},"PeriodicalIF":4.6000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11756302/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Kidney Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ckj/sfae353","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
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Abstract
Background: Neurovascular coupling (NVC), as indicated by a comprehensive analysis of the amplitude of low-frequency fluctuation (ALFF) and cerebral blood flow (CBF), provides mechanistic insights into neurological disorders. Patients undergoing peritoneal dialysis (PD) and hemodialysis (HD) often face cognitive impairment, the causes of which are not fully understood.
Methods: ALFF was derived from functional magnetic resonance imaging, and CBF was quantified using arterial spin labeling in a cohort comprising 58 patients with PD, 60 patients with HD and 62 healthy controls. Voxel-based global analysis for both ALFF and CBF, alongside region-based analyses of ALFF-CBF coupling coefficients, were conducted. Additionally, the study explored the correlation between clinical laboratory indices and imaging metrics.
Results: Compared with HC, NVC was reduced in the bilateral medial superior frontal gyrus (SFGmed), insula, posterior cingulate cortex (PCC) and caudate (CAU) among dialysis patients. Furthermore, the PD group exhibited lower NVC in the bilateral SFGmed, bilateral PCC and left CAU compared with the HD group. Within the PD group, sodium level was negatively correlated with the ALFF-CBF coupling coefficient in the right insula. Additionally, a positive correlation emerged between the ALFF-CBF coupling coefficient in bilateral SFGmed and the dialysis adequacy.
Conclusion: While Montreal Cognitive Assessment scores did not significantly differ between patients with PD and HD, PD group demonstrated poorer NVC in the bilateral SFGmed, bilateral PCC and left CAU. Sodium level and dialysis adequacy may affect NVC in patients with PD.
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Clinical Kidney Journal: Clinical and Translational Nephrology (ckj), an official journal of the ERA-EDTA (European Renal Association-European Dialysis and Transplant Association), is a fully open access, online only journal publishing bimonthly. The journal is an essential educational and training resource integrating clinical, translational and educational research into clinical practice. ckj aims to contribute to a translational research culture among nephrologists and kidney pathologists that helps close the gap between basic researchers and practicing clinicians and promote sorely needed innovation in the Nephrology field. All research articles in this journal have undergone peer review.
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