Study On The Cognitive Impairment Of Patients With End-stage Renal Disease By Resting State Functional Resonance Imaging

Objective: Based on resting state functional magnetic resonance imaging(rs-fMRI)combined with regional homogeneity analysis(ReHo)and fractional amplitude of low frequency fluctuation(fALFF)analysis to analyze whether there are abnormal brain function changes in patients with end-stage renal disease(ESRD);assess the degree of cognitive impairment in patients with ESRD;to further explore the correlation between abnormal brain function and cognitive impairment in patients with end-stage renal disease.Methods:The study included 33 patients with end-stage renal disease without hemodialysis(non-dialysis group),33 patients with end-stage renal disease who received regular hemodialysis(dialysis group),and 33 healthy volunteers matched with the gender,age,and education years of the previous two groups(control group).Cognitive tests(MMSE,Mo CA)were performed in all three groups,and MRI examinations were performed within 24 hours.The difference between the ReHo value and the fALFF value among the three groups was compared,and the correlation analysis was performed with the cognitive score.Result:1.The cognitive function of the dialysis group and the non-dialysis group decreased to varying degrees compared with the control group,and the cognitive score of the dialysis group was higher than that of the non-dialysis group.2.Comparison of differences in ReHo value and fALFF value between groups:1)Comparison of differences in ReHo values between groups: Compar ed with the control group,the ReHo values of the bilateral middle orbital middle frontal gyrus and the bilateral insula of the non-dialysis group decr eased;compared with the control group,the bilateral orbital of the dialysis group Middle frontal gyrus,bilateral medial superior frontal gyrus,bilateral anterior cingulate and lateral cingulate gyrus,left superior temporal gyrus,bilateral orbital inferior frontal gyrus,left middle temporal gyrus,left midd le frontal gyrus,left The ReHo value of the lateral insula and the frontal gyrus of the right triangle decreased,and the ReHo value of the left caud ate nucleus increased;compared with the non-dialysis group,the left inferi or temporal gyrus,left hippocampus,and left legumes of the dialysis grou p The ReHo value of the putamen decreases.2)Comparison of differences in fALFF values between groups:.compared with the control group,in the undialysis group,the fALFF value of the left inferior temporal gyrus,the bilateral medial superior frontal gyrus,the bilateral middle frontal gyrus,the right intraorbital superior frontal gyrus,the right middle temporal gyrus,the left orbital frontal gyrus,the inferior frontal gyrus of the left orbit and the inferior frontal gyrus of the left triangle are decreases,and the fALFF value of the right parahippocampal gyrus increase;compared with the control group,The fALFF values of the right temporal pole superior temporal gyrus,the left orbit inferior frontal gyrus,the bilateral medial superior frontal gyrus,the left orbital middle frontal gyrus,the right superior temporal gyrus,the left middle temporal gyrus,the left triangle inferior frontal gyrus,and the right insulaare decreases,the fALFF value of the left thalamus,the right lenticular globus,the right anterior cingulate and the lateral cingulate gyrus are increased;compared with the non-dialysis group,the fALFF value of the hippocampus on both sides of the dialysis group decreased,and the fALFF value of the bilateral frontal middle gyrus,the right motor supplement area,the left inferior temporal gyrus,and left lingual gyrus increased.3.Correlation analysis of fALFF value,ReHo value and cognitive score of the brain regions with differences among the three groups: fALFF value: right insula(r=0.5199,P=0.0054),right superior temporal gyrus in dialysis group(r=0.6231,P=0.0005),the left inferior frontal gyrus of the orbit(r=0.3951,P=0.0414)is positively correlated with the cognitive score,the left inferior temporal gyrus(r=-0.7170,P<0.0001)and the left The lateral hippocampus(r=-0.5145,P=0.0060)was negatively correlated with the cognitive score.The left middle frontal gyrus(r=0.4412,P=0.0398)and the left inferior temporal gyrus(r=0.7309,P =0.0001)was positively correlated with cognitive score,and the right middle temporal gyrus(r=-0.6637,P=0.0008)was negatively correlated with cognitive score.ReHo value: the left middle temporal gyrus(r=0.5768,P=0.0016)of the dialysis group was positively correlated with the cognitive score,there was no statistical correlation between different brain regions and cognitive scores in the non-dialysis group(P>0.05).Conclusion:ESRD patients have different degrees of cognitive impairment.The two analysis methods of fALFF and ReHo found that abnormally active brain areas such as the frontal lobe,temporal lobe and insula of ESRD patients are related to cognitive impairment,and the hippocampus may be involved in hemodialysis regulation of patients’ cognitive function.These abnormally active neuronal brain areas shown by rs-fMRI may provide objective imaging evidence for further exploring the pathogenesis and regulation mechanisms of cognitive impairment in patients with end-stage renal disease.