| PurposeIn this study,the regional homogeneity(ReHo),functional connectivity(FC),dynamic regional homogeneity(d-ReHo)and dynamic amplitude of low frequency fluctuations(d-ALFF)analysis methods of resting state functional magnetic resonance image(rs-fMRI)were used to investigate the local brain function alteration mode of end stage renal disease(ESRD).Materials and methodsThis study included 20 patients with ESRD and 20 healthy subjects with similar age,gender and education.All subjects underwent a series of neuropsychological tests and collected the blood biochemical examination results of patients.This study includes three parts:(Ⅰ)ReHo algorithm and two sample t-test were used to compare the differences of local brain function between the two groups,and then the ReHo value of altered brain areas in patients with ESRD was extracted and analyzed for partial correlation with neuropsychological test,biochemical test results and dialysis duration.(Ⅱ)Taking the brain regions with differential ReHo value obtained in the part Ⅰ as the region of interests,the FC algorithm and two sample t-test were used to compare the difference of functional integration between the two groups,and then the z-scores of the altered FC brain regions of ESRD patients were extracted for partial correlation analysis with their neuropsychological test,biochemical test results and dialysis duration.(Ⅲ)d-ReHo,d-ALFF algorithm and two sample t-test were used to compare the differences of dynamic brain activity between the two groups,and then the d-ReHo value and d-ALFF value in altred brain areas of ESRD patients were extracted for partial correlation analysis with their neuropsychological test,biochemical test results and dialysis duration.ResultThere were significant differences between groups in the results of SAS,SDS,MoCA,NCT-A,DST,SDT,and LTT.The results of the three parts:(Ⅰ)Compared with the control group,the ReHo values of the right precentral gyrus(PreCG),right cuneus,left superior temporal gyrus(STG)and middle temporal gyrus(MTG)were decreased in patients with ESRD.(Ⅱ)Compared with the control group,the functional connection between left STG-bilateral STG,right cuneus-left cuneus,left MTG-bilateral MTG and right STG,right PreCG-bilateral postcentral gyrus were decreased,while the functional connection between left MTG and right inferior parietal lobule was increased.The z-score of right STG in patients with ESRD was positively correlated with MoCA score while negatively correlated with NCT-A score.(Ⅲ)Compared with the control group,the d-ReHo variability of the right middle frontal gyrus in ESRD patients was significantly increased;The d-ALFF variability of right MTG and left inferior temporal gyrus were significantly increased,but the d-LFF variability of bilateral precuneus,left superior parietal lobule and right PreCG were significantly decreased.The increased d-ALFF value of left inferior temporal gyrus was positively correlated with LTT score.Conclusion(Ⅰ)Patients with ESRD suffer from anxiety,depression,and cognitive impairment,especially in information processing speed,task execution ability and attention.The activity of neurons in multiple brain regions of patients with ESRD is weakened.ReHo can be used as a reliable imaging index to reflect the activity of local neurons in resting magnetic resonance analysis.(Ⅱ)The brain areas with reduced FC values in patients with ESRD are mainly located in the temporal lobe and parietal lobe,which are related to vision,memory,hearing,movement and language.FC abnormality of right STG may be an important imaging index of cognitive impairment.(Ⅲ)The neuronal activity in frontal lobe and temporal lobe in patients with ESRD were unstable,while the dynamic neuronal activity in parietal lobe and part of frontal lobe were decreased.Abnormal brain activity in temporal lobe plays an important role in cognitive impairment in patients with ESRD.Dynamic regional index can be a powerful supplement to static regional index. |
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