Clinical Research
Changes of functional brain networks and their relations with cognitive function in patients with end-stage renal disease
Wu Baolin, Yue Zheng, Li Xuekun, Li Lei, Zhang Meng, Ren Jipeng, Liu Wenling, Han Dongming
Published 2020-02-15
Cite as Chin J Neuromed, 2020,19(02): 181-187. DOI: 10.3760/cma.j.issn.1671-8925.2020.02.012
Abstract
ObjectiveTo investigate the change patterns of functional brain networks and their relations with cognitive function in patients with end-stage renal disease (ESRD).
MethodsSixty-two patients with ESRD (ESRD group), admitted to our hospital from July 2018 to June 2019, and 36 age-, gender-, and education level-matched healthy controls (HC group) were enrolled. Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Trail Making Test A (TMT-A), TMT-B and Symbol Digit Modalities Test (SDMT) were used to evaluate the cognitive function for all subjects. Resting-state functional magnetic resonance imaging data were acquired; after data preprocessing, the brain functional networks were constructed and the topological parameters were calculated. Statistical methods were used to compare the differences of cognitive function scores and topological parameters between the two groups, and to analyze the correlations between these topological parameters and cognitive function scores in the ESRD group.
ResultsThe MMSE, MoCA and SDMT scores of the ESRD group were significantly lower than those of the HC group (P<0.05), and the ESRD group took significantly longer time to complete TMT-A and TMT-B than the HC group (P<0.05). The ESRD group had significantly lower normalized clustering coefficient (γ), small-worldness (σ) and local efficiency (Elocal) values than the HC group (P<0.05). Patients in the ESRD group exhibited significantly decreased nodal efficiency in the paralimbic-limbic network (including the bilateral insula, median cingulate and paracingulate gyri, hippocampus, parahippocampal gyrus, amygdala, temporal pole: superior temporal gyrus, and temporal pole: middle temporal gyrus), right heschl gyrus and left superior temporal gyrus, and exhibited significantly increased nodal efficiency in the visual network (including the right distal-shaped gyrus, bilateral wedge, and left superior and middle occipital gyrus) as compared with the HC group (P< 0.05). In the ESRD group, the area under the curve (AUC) of γ and σwas positively correlated with MoCA scores (r=0.698, P=0.000; r=0.661, P=0.000), and the AUC of Elocal showed positive correlation with MMSE scores (r=0.407, P=0.003).
ConclusionAbnormal topological organization of the functional brain networks is revealed in patients with ESRD, which affects the cognitive function of these patients.
Key words:
End-stage renal disease; Cognitive impairment; Functional brain network; Resting-state functional magnetic resonance imaging; Graph theory
Contributor Information
Wu Baolin
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China
Yue Zheng
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China
Li Xuekun
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China
Li Lei
Huaxi Magnetic Resonance Research Center, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China
Zhang Meng
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China
Ren Jipeng
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China
Liu Wenling
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China
Han Dongming
Department of Magnetic Resonance, First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453100, China