Indices of adrenal deficiency involved in brain plasticity and functional control reorganization in hemodialysis patients with polysulfone membrane: BOLD-fMRI study

Abstract

This work purpose was to estimate the implication of suspected adrenal function deficiencies, which was influenced by oxidative stress (OS) that are generating brain plasticity, and reorganization of the functional control. This phenomenon was revealed in two-hemodialysis patients described in this paper. Blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI) revealed a significant activation of the motor cortex. Hemodialysis seems to originate an inflammatory state of the cerebral tissue reflected by increased OS, while expected to decrease since hemodialysis eliminates free radicals responsible for OS. Considering adrenal function deficiencies, sensitivity to OS and assessed hyponatremia and hypercalcemia, adrenal function deficiencies is strongly suspected in both patients. This probably contributes to amplify brain plasticity and a reorganization of functional control after hemodialysis that is compared to earlier reported studies. Brain plasticity and functional control reorganization was revealed by BOLD-fMRI with a remarkable sensitivity. Brain plastic changes are originated by elevated OS associating indices of adrenal function deficiencies. These results raise important issues about adrenal functional deficiencies impact on brain plasticity in chronic hemodialysis-patients. This motivates more global studies of plasticity induced factors in this category of patients including adrenal functional deficiencies and OS.

Blood Oxygenation Level-Dependent Functional MRI of Early Evidences of Brain Plasticity after Hemodialysis Session by Helixone Membrane of Patients with Indices of Adrenal Deficiency

“…This imbalance leads to cell and tissue injury [12] . Since the brain is involved in most metabolic processes, it is highly exposed to OS [13,14,20] . Hence, BOLD-fMRI is a suitable imaging approach allowing spatial localization of the brain oxygenation change [8][9][10][11][12][13][14][15]21] .…”

“…Hence, BOLD-fMRI is a suitable imaging approach allowing spatial localization of the brain oxygenation change [8][9][10][11][12][13][14][15]21] . This technique is also used to assess BOLD phenomena that are directly linked to brain activity/plasticity and OS [7,8,13,14,[20][21][22][23][24][25][26][27][28][29] . It is well-known that CRF disease itself is a direct factor originating OS before HD sessions [7,8,13,14,[20][21][22][23][24] .…”

“…They gave consent to participate to our fMRI study conducted by Clinical Neuroscience Laboratory, Faculty of Medicine and Pharmacy of Fez, University of Fez in collaboration with Nephrology Department, Radiology and Clinical Imaging Department, and the Central Laboratory of the University Hospital of Fez, Fez, Morocco [7,8,13,14,20,21] .…”

“…The acquisition of images was done using single-shot gradient-echo echo-planer imaging sequence. This approach was shown to be very sensitive to T2 * effect generated during BOLD effect reflecting functional activity of the cortical brain tissue [13,14,[20][21][22] . BOLD-fMRI acquisition parameters were the following: echo time TE = 55 ms, repetition time TR = 3,000 ms, slice thickness = 5 mm, field of view FOV = 240 mm, and 31 axial slices were acquired covering the whole brain.…”

“…Besides, it was recently established that the blood oxygenation level-dependent functional MRI (BOLD-fMRI) was an efficient technique for evaluating OS in chronic HD patients [13,14,[20][21][22][23][24][25] . Hence, the goal of this paper was to evaluate indirect indices of the AG dysfunction in patients undergoing HD by the synthetic helixone membrane.…”