Abstract
Abnormal brain structural connectivity of end-stage renal disease (ESRD) is associated with cognitive impairment. However, the characteristics of cortical structural connectivity have not been investigated in ESRD patients. The current study aimed to investigate the structural connectivity of the entire cerebral cortex in ESRD patients. Twenty-five ESRD patients and 20 healthy controls were recruited for this study; all participants underwent diffusion tensor imaging and high-resolution T1-weighted imaging scanning. Fiber connectivity density (FiCD) mapping was performed to calculate structural connectivity of the whole cortex, and between-group differences were compared in a vertexwise manner. We also tested the associations between FiCD changes and clinical information using Pearson correlation analysis. The results demonstrated that the mean global FiCD value was significantly decreased in ESRD patients compared with that of HCs. Notably, FiCD values were significantly changed (decreased or increased) in certain cortical regions, which mainly involved the bilateral dorsolateral prefrontal cortex (DLPFC), inferior parietal, lateral temporal and middle occipital cortex (P < 0.01 with Monte Carlo correction). Moreover, in ESRD patients, the increased FiCD values in the right middle frontal gyrus were negatively correlated with serum creatinine (r=-0.473, p = 0.017) and urea levels (r=-0.511, p = 0.009). The increased FiCD values in the left middle frontal gyrus were negatively correlated with dialysis duration (r=-0.577, p = 0.003) and parathyroid hormone (PTH) levels (r=-0.552, p = 0.004). Our results suggested that ESRD patients exhibited extensive impaired cortical structural connectivity. And there may be a compensation mechanism of cortical structural recombination that plays a role in the way the brain adapts to maintain optimal network function. Moreover, serum creatinine, urea and PTH levels may be risk factors for brain structural network decompensation in ESRD patients.
Fiber connectivity density mapping in end-stage renal disease patients: a preliminary study
