Evaluation of Mental Disorders Using Proton Magnetic Resonance Spectroscopy in Dialysis and Predialysis Patients

Abstract

Background/Aims: Psychological complications are prevalent in patients with chronic kidney disease (CKD). This study aimed to investigate mental disorders in stage 4-5 CKD patients, to detect metabolite concentrations in the brain by proton magnetic resonance spectroscopy (¹H-MRS) and to compare the effects of different dialysis therapies on mental disorders in end-stage renal disease (ESRD). Methods: The sample population was made up of predialysis (13), hemodialysis (HD) (13), and peritoneal dialysis (PD) patients (12). We collected the baseline data of patients’ age, sex, hemoglobin (Hb) and parathyroid hormone（PTH） levels. The predialysis patients served as the control group. The psychological status of the three groups was assessed using three psychological scales. ¹H-MRS was used to evaluate the relative metabolite concentrations in the bilateral amygdala, hippocampus and unilateral anterior cingulated cortex (ACC). Results: The psychological status was better in HD patients than in predialysis and PD patients. ¹H-MRS alterations were predominantly found in the ACC. Choline-containing compounds relative to creatine (Cho/Cr), myo-inositol relative to creatine (MI/Cr) and glutamate and glutamine relative to creatine (Glx/Cr) in the ACC were higher in HD patients. ¹H-MRS results were correlated with the baseline data and the scores of psychological scales. Conclusions: CKD patients showed different types of mental disorders as well as metabolite disturbances in the brain. The metabolite concentrations correlated with the psychological status which was better in HD than in predialytic and PD patients.

Brain Functional Networks with Dynamic Hypergraph Manifold Regularization for Classification of End-Stage Renal Disease Associated with Mild Cognitive Impairment

“…For example, previous voxel-based morphometrics, surface-based morphometrics, and diffusion tensor imaging studies have revealed defects in gray matter volume and reduced cortical thickness [11], as well as reduced white matter integrity [12] in ESRD patients. In addition, various analyses, including arterial spin labeling [13], magnetic resonance spectroscopy [14], and single-photon emission tomography [15], have found abnormalities in brain metabolism and function in ESRD patients treated with HD.…”

Abnormal brain functional networks in end‐stage renal disease patients with cognitive impairment

“…For example, previous studies with voxel‐based morphometry, surface‐based morphometry, and diffusion tensor imaging (DTI) revealed gray matter volume deficits (Qiu et al., 2014; L. J. Zhang et al., 2013), decreased cortical thickness (Dong et al., 2018), and reduced white matter integrity (Drew et al., 2017; R. Zhang et al., 2015) in patients with ESRD. In addition, cerebral metabolic and functional abnormalities were demonstrated in ESRD patients who underwent HD using different analyses, including arterial spin labeling (Jiang et al., 2016), magnetic resonance spectroscopy (C. Y. Zhang et al., 2017), and single‐photon emission tomography (Polinder‐Bos et al., 2020).…”

Characterizing Topological Properties of Brain Functional Networks Using Multi-Threshold Derivative for End-Stage Renal Disease with Mild Cognitive Impairment

“…Furthermore, various analysis methods also can help to identify brain metabolism and function abnormalities in ESRD patients receiving HD treatment. These methods include arterial spin labeling [ 14 ], magnetic resonance spectroscopy [ 15 ], and single photon emission computed tomography [ 16 ]. Moreover, fractal analysis can be utilized for revealing the complexity and dynamics of EEG signals in ESRD patients to fully comprehend the function and connectivity of brain networks.…”