Reduced White Matter Integrity in Patients With End-Stage and Non-end-Stage Chronic Kidney Disease: A Tract-Based Spatial Statistics Study

Jiang, Yuhan; Gao, Qiuyi; Liu, Yangyingqiu; Gao, Bingbing; Che, Yiwei; Lin, Liangjie; Jiang, Jian; Chang, Peipei; Song, Qingwei; Wang, Weiwei; Wang, Nan; Miao, Yanwei

doi:10.3389/fnhum.2021.774236

Cited by 10 publications

(5 citation statements)

References 44 publications

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“…The increase in MD, which represents the mean diffusivity of water molecules, may be due to the loss of axons and myelin sheaths and the increase in extracellular fluid. Such alterations align with previous studies that reported decreased FA and increased MD in CKD patients’ white matter ( 8 , 23 , 24 ). The inclusion of AD and RD in our analysis offers a more comprehensive understanding, as they indicate water molecules dispersion parallel and perpendicular to the fiber orientation, hinting at axon integrity and myelin damage.…”

Section: Discussionsupporting

confidence: 92%

“…The inclusion of AD and RD in our analysis offers a more comprehensive understanding, as they indicate water molecules dispersion parallel and perpendicular to the fiber orientation, hinting at axon integrity and myelin damage. Moreover, our study uniquely identified reduced FA in the middle cerebellar peduncle, with only one similar finding reported previously ( 24 ).…”

Section: Discussionsupporting

confidence: 92%

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Assessing brain microstructural changes in chronic kidney disease: a diffusion imaging study using multiple models

Han,

Yang,

Yuan

et al. 2024

Front. Neurol.

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ObjectivesTo explore the effectiveness of diffusion quantitative parameters derived from advanced diffusion models in detecting brain microstructural changes in patients with chronic kidney disease (CKD).MethodsThe study comprised 44 CKD patients (eGFR<59 mL/min/1.73 m2) and 35 age-and sex-matched healthy controls. All patients underwent diffusion spectrum imaging (DSI) and conventional magnetic resonance imaging. Reconstructed to obtain diffusion MRI models, including diffusion tensor imaging (DTI), neurite orientation dispersion and density imaging (NODDI) and Mean Apparent Propagator (MAP)-MRI, were processed to obtain multi-parameter maps. The Tract-Based Spatial Statistics (TBSS) analysis was utilized for detecting microstructural differences and Pearson correlation analysis assessed the relationship between renal metabolism markers and diffusion parameters in the brain regions of CKD patients. Receiver operating characteristic (ROC) curve analysis assessed the diagnostic performance of diffusion models, with AUC comparisons made using DeLong’s method.ResultsSignificant differences were noted in DTI, NODDI, and MAP-MRI parameters between CKD patients and controls (p < 0.05). DTI indicated a decrease in Fractional Anisotropy(FA) and an increase in Mean and Radial Diffusivity (MD and RD) in CKD patients. NODDI indicated decreased Intracellular and increased Extracellular Volume Fractions (ICVF and ECVF). MAP-MRI identified extensive microstructural changes, with elevated Mean Squared Displacement (MSD) and Q-space Inverse Variance (QIV) values, and reduced Non-Gaussianity (NG), Axial Non-Gaussianity (NGAx), Radial Non-Gaussianity (NGRad), Return-to-Origin Probability (RTOP), Return-to-Axis Probability (RTAP), and Return-to-Plane Probability (RTPP). There was a moderate correlation between serum uric acid (SUA) and diffusion parameters in six brain regions (p < 0.05). ROC analysis showed the AUC values of DTI_FA ranged from 0.70 to 0.793. MAP_NGAx in the Retrolenticular part of the internal capsule R reported a high AUC value of 0.843 (p < 0.05), which was not significantly different from other diffusion parameters (p > 0.05).ConclusionThe advanced diffusion models (DTI, NODDI, and MAP-MRI) are promising for detecting brain microstructural changes in CKD patients, offering significant insights into CKD-affected brain areas.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 92%

Assessing brain microstructural changes in chronic kidney disease: a diffusion imaging study using multiple models

Han,

Yang,

Yuan

et al. 2024

Front. Neurol.

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“…In addition, Yu et al found that decreased volume of hippocampus predicted deterioration of fornix microstructure 38 . Our previous study identified the vulnerability of the fornix microstructure in ESRD patients 39 . Therefore, based on the location of the fimbria in the hippocampus and the anatomical relationship with the fornix, we speculate that the change of fimbria volume may be related to the microstructure of the fornix.…”

Section: Discussionmentioning

confidence: 99%

Relations of hippocampal subfields atrophy patterns with memory and biochemical changes in end stage renal disease

Jiang

Gao

et al. 2023

Sci Rep

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End-stage renal disease (ESRD) results in hippocampal volume reduction, but the hippocampal subfields atrophy patterns cannot be identified. We explored the volumes and asymmetry of the hippocampal subfields and their relationships with memory function and biochemical changes. Hippocampal global and subfields volumes were derived from 33 ESRD patients and 46 healthy controls (HCs) from structural MRI. We compared the volume and asymmetric index of each subfield, with receiver operating characteristic curve analysis to evaluate the differentiation between ESRD and HCs. The relations of hippocampal subfield volumes with memory performance and biochemical data were investigated in ESRD group. ESRD patients had smaller hippocampal subfield volumes, mainly in the left CA1 body, left fimbria, right molecular layer head, right molecular layer body and right HATA. The right molecular layer body exhibited the highest accuracy for differentiating ESRD from HCs, with a sensitivity of 80.43% and specificity of 72.73%. Worse learning process (r = 0.414, p = 0.032), immediate recall (r = 0.396, p = 0.041) and delayed recall (r = 0.482, p = 0.011) was associated with left fimbria atrophy. The left fimbria volume was positively correlated with Hb (r = 0.388, p = 0.05); the left CA1 body volume was negatively correlated with Urea (r = − 0.469, p = 0.016). ESRD patients showed global and hippocampal subfields atrophy. Left fimbria atrophy was related to memory function. Anemia and Urea level may be associated with the atrophy of left fimbria and CA1 body, respectively.

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“…One plausible explanation is that TBSS may be better suited for detecting significant white matter abnormalities ( 39 ). For instance, it exhibits sensitivity towards long-term exposure-induced structural alterations ( 40 ) or structural changes linked to severe injuries like Traumatic Brain Injury ( 41 ). However, the focus of the research cohort pertained predominantly to children who had recently received a diagnosis of ADHD.…”

Section: Discussionmentioning

confidence: 99%

Microstructure abnormalities of the diffusion quantities in children with attention-deficit/hyperactivity disorder: an AFQ and TBSS study

Hu,

Tan,

Chen

et al. 2023

Front. Psychiatry

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ObjectiveTo explore the specific alterations of white matter microstructure in children with attention-deficit/hyperactivity disorder (ADHD) by automated fiber quantification (AFQ) and tract-based spatial statistics (TBSS), and to analyze the correlation between white matter abnormality and impairment of executive function.MethodsIn this prospective study, a total of twenty-seven patients diagnosed with ADHD (20 males, 7 females; mean age of 8.89 ± 1.67 years) and twenty-two healthy control (HC) individuals (11 males, 11 females, mean age of 9.82 ± 2.13 years) were included. All participants were scanned with diffusion kurtosis imaging (DKI) and assessed for executive functions. AFQ and TBSS analysis methods were used to investigate the white matter fiber impairment of ADHD patients, respectively. Axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD) and fractional anisotropy (FA) of 17 fiber properties were calculated using the AFQ. The mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), mean diffusivity (MDDKI), axial diffusivity (ADDKI), radial diffusivity (RDDKI) and fractional anisotropy (FADKI) of DKI and AD, RD, MD, and FA of diffusion tensor imaging (DTI) assessed the integrity of the white matter based on TBSS. Partial correlation analyses were conducted to evaluate the correlation between white matter abnormalities and clinical test scores in ADHD while taking age, gender, and education years into account. The analyses were all family-wise error rate (FWE) corrected.ResultsADHD patients performed worse on the Behavior Rating Inventory of Executive Function (BRIEF) test (p < 0.05). Minor variances existed in gender and age between ADHD and HC, but these variances did not yield statistically significant distinctions. There were no significant differences in TBSS for DKI and DTI parameters (p > 0.05, TFCE-corrected). Compared to HC volunteers, the mean AD value of right cingulum bundle (CB_R) fiber tract showed a significantly higher level in ADHD patients following the correction of FWE. As a result of the point-wise comparison between groups, significant alterations (FWE correction, p < 0.05) were mainly located in AD (nodes 36–38, nodes 83–97) and MD (nodes 92–95) of CB_R. There was no significant correlation between white matter diffusion parameters and clinical test scores in ADHD while taking age, gender, and education years into account.ConclusionThe AFQ method can detect ADHD white matter abnormalities in a specific location with greater sensitivity, and the CB_R played a critical role. Our findings may be helpful in further studying the relationship between focal white matter abnormalities and ADHD.

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Reduced White Matter Integrity in Patients With End-Stage and Non-end-Stage Chronic Kidney Disease: A Tract-Based Spatial Statistics Study

Cited by 10 publications

References 44 publications

Assessing brain microstructural changes in chronic kidney disease: a diffusion imaging study using multiple models

Assessing brain microstructural changes in chronic kidney disease: a diffusion imaging study using multiple models

Relations of hippocampal subfields atrophy patterns with memory and biochemical changes in end stage renal disease

Microstructure abnormalities of the diffusion quantities in children with attention-deficit/hyperactivity disorder: an AFQ and TBSS study

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