Spatial Disassociation of Disrupted Functional Connectivity for the Default Mode Network in Patients with End-Stage Renal Disease

Ma, Xiaofen; Jian-guo, Tian; Wu, Zhanhong; Zong, Xiaopeng; Dong, Jingcheng; Zhan, Wang; Xu, Yikai; Li, Zibo; Jiang, Guihua

doi:10.1371/journal.pone.0161392

Cited by 14 publications

(15 citation statements)

References 62 publications

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“…Anemia is associated with the increased risk of cognitive decline and dementia in the general population (Shah et al, 2011) and ESRD patients (Kurella Tamura et al, 2011), which can be improved after anemia treatment with erythropoietin (Hung et al, 2019). Recent ESRD patient research found weaken FC were significantly correlated with anemia and poor neuropsychological test performance (Zheng et al, 2014;Luo et al, 2016;Ma et al, 2016;Zhang et al, 2016). It may be caused by long-term hemodialysis and reduced hemoglobin could lead to cerebral dysfunction in oxygenation and regulation in CBF (Jiang et al, 2016;Zheng et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

How Do You Feel Now? The Salience Network Functional Connectivity in End-Stage Renal Disease

Gao

Chen

et al. 2020

Front. Neurosci.

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Objective The network connectivity basis of cognitive declines in end-stage renal disease (ESRD) remains unclear. A triple-network model of the salience (SN), executive control, and default mode networks has been suggested to be critical for efficient cognition. Here, we aimed to test the hypothesis that SN may play a role in cognitive impairment in patients with ESRD. Materials and Methods We investigated functional connectivity (FC) alterations within the SN between 43 ESRD patients (19 females/24 males, 46 ± 10 years) and 43 healthy controls (HC) (19 females/24 males, 47 ± 10 years), and performed linear support vector machine (LSVM) analysis on significant FC pairs within the SN to discriminate the two groups, and tested the accuracy of the classifier. Association and mediation analyses were conducted among the significant FC pairs within the SN nodes, clinical indicators, and neuropsychological tests scores. Results We identified significant between-group FC pairs within the SN and fairly good classification efficiency with significant accuracy (72.09%, p < 0.001). We found that FC between the right supramarginal gyrus and right anterior insula (AISL) was positively correlated with MoCA ( r = 0.4010, p = 0.008); FC between the dorsal anterior cingulate cortex (dACC) and left AISL was positively correlated with the level of hemoglobin ( r = 0.4979, p < 0.001). Mediation analysis found that the indirect effect of hemoglobin on forward digit span test scores via the FC between the dACC and right AISL ( p < 0.05). Conclusion Disrupted SN connectivity may help explain cognitive declines in ESRD patients and act as a potential early biomarker. Moreover, the SN connectivity may interact with anemia to promote cognitive impairment.

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Section: Discussionmentioning

confidence: 99%

How Do You Feel Now? The Salience Network Functional Connectivity in End-Stage Renal Disease

Gao

Chen

et al. 2020

Front. Neurosci.

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“…Abnormal brain functional connectivity was also observed in ESRD patients with resting-state functional MRI (r-fMRI) [ 9 ]. For example, an r-fMRI study found that ESRD patients exhibited significantly decreased functional connectivity with the posterior cingulate cortex (PCC) in the left middle temporal gyrus, the right anterior cingulate gyrus, and the bilateral medial superior frontal gyrus, which suggested a spatially specific disruption of functional connectivity of the default mode network (DMN) [ 10 ]. In addition to this fMRI study, there were also some structural abnormalities reported in ESRD patients, and some diffusion tensor imaging (DTI) studies detected changes in the WM in ESRD patients using several analytical methods, including region of interest (ROI) [ 9 ], voxel-based analysis (VBA) [ 11 ], and diffusion tensor tractographies (DTTs) [ 12 ], these studies found some microstructural abnormalities in ESRD patients, for example, the VBA study concluded that voxelwise DTI analysis is helpful in the detection of white matter alterations caused by hemodialysis.…”

Section: Introductionmentioning

confidence: 99%

Reduced White Matter Integrity With Cognitive Impairments in End Stage Renal Disease

Yin¹,

Li²,

Li³

et al. 2018

Front. Psychiatry

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Background: End-stage renal disease (ESRD) is a serious public health problem, which can often lead to multiorgan dysfunction, such as cerebrovascular disease and cognitive damage. It is essential to understand cognitive impairment in patients with ESRD to develop better ESRD treatment and prevent further cognitive impairment. Cognitive impairment is believed to be related to structural abnormalities in the brain.Purpose: To investigate white matter microstructural abnormalities in patients with ESRD using TBSS analysis of DTI and to explore the possible mechanisms underlying the impaired cognitive function.Materials and Methods: A TBSS analysis of DTI data was to investigate the microstructural changes in their WM over the whole brain. We chose the white matter tracts or regions with significantly reduced FA as the regions of interest (ROIs), Pearson's correlations were performed between clinical indicators (Mini-Mental State Examination (MMSE), digit span task scores, serum creatinine, blood urea nitrogen and hemodialysis duration) and the mean FA value of the ROIs in the ESRD patients.Results: Lower FA and higher MD, AD and RD values were observed in widespread and symmetrical WM in ESRD patients than healthy controls (HCs), Pearson correlation analysis revealed a significantly positive correlation between the Mini-Mental State Examination (MMSE) scores and FA values in the right corona radiata and left anterior thalamic radiation (ATR) and demonstrated a significantly negative correlation between FA values and the serum creatinine and blood urea nitrogen in the ATR (P < 0.01) in addition, digit span task scores positively correlate with the FA value in the left anterior rather than in the corona radiata. No cluster survived when we adopted the False Discovery Rate (FDR) correction to multiple comparisons.Conclusion: Our study indicate widespread impairment of the white matter in ESRD patients. Damage to the thalamic radiation and corona radiata may affect cognitive function in ESRD patients, the reduced integrity of ATR may tend to affect the working memory while the damage to the corona radiata may involve the executive function impaired in ESRD patients. The accumulation of serum creatinine and blood urea nitrogen may contribute to the WM impairment.

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“…Several fMRI studies have a similar finding, that is, disrupted functional integration in ESRD, particularly in the prefrontal cortex. 10 , 11 This evidence suggests that prefrontal cortex plays a decisive role in the progress of cognitive impairment in ESRD and is a potential observation indicator of cognitive change in ESRD.…”

Section: Discussionmentioning

confidence: 99%

“…Neuroimaging techniques provide potential avenues for these goals and enable the detection of ESRD-related abnormalities in white matter (WM) integrity, 6 – 8 gray matter (GM) volume, 9 and functional architecture. 10 , 11 These pioneering studies have largely contributed to our understanding of the disease. However, the neuropathologic substrate underlying ESRD cannot be established well, particularly at the structure level from a cortical GM morphology perspective.…”

Section: Introductionmentioning

confidence: 99%

Aberrant cortical thickness in neurologically asymptomatic patients with end-stage renal disease

Dong¹,

Ma²,

Lin³

et al. 2018

NDT

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PurposeThe aim of this study is to investigate the morphology of cortical gray matter in patients with end-stage renal disease (ESRD) and the relationship between cortical thickness and kidney function.Patients and methodsThree-dimensional high-resolution brain structural magnetic resonance imaging data were collected from 35 patients with ESRD (28 men, 18–61 years old) and 40 age- and gender-matched healthy controls (HCs, 32 men, 22–58 years old). Vertex-wise analysis was then performed to compare the brains of the patients with ESRD with those of HCs to identify abnormalities in the brains of the former. Multiple biochemical measures of renal metabolin, vascular risk factors, general cognitive ability, and dialysis duration were correlated with brain morphometry alterations for the patients.ResultsPatients with ESRD showed lesser cortical thickness than the HCs. The most significant cluster with decreased cortical thickness was found in the right prefrontal cortex (P<0.05, random-field theory correction). In addition, the four local peak vertices in the prefrontal cluster were lateral prefrontal cortex (Peaks 1 and 2), medial prefrontal cortex (Peak 3), and ventral prefrontal cortex (Peak 4). Significant negative correlations were observed between the cortical thicknesses of all four peak vertices and blood urea nitrogen; a negative correlation, between the cortical thickness in three of four peaks and serum creatinine; and a positive correlation, between cortical thickness in the medial prefrontal cortex (Peak 3) and hemoglobin.ConclusionThese results provided compelling evidence for cortical abnormality of ESRD patients and suggested that kidney function may be the key factor for predicting changes of brain tissue structure.

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Spatial Disassociation of Disrupted Functional Connectivity for the Default Mode Network in Patients with End-Stage Renal Disease

Cited by 14 publications

References 62 publications

How Do You Feel Now? The Salience Network Functional Connectivity in End-Stage Renal Disease

How Do You Feel Now? The Salience Network Functional Connectivity in End-Stage Renal Disease

Reduced White Matter Integrity With Cognitive Impairments in End Stage Renal Disease

Aberrant cortical thickness in neurologically asymptomatic patients with end-stage renal disease

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