Rationale and Objectives
The goal of this study was to investigate the relationship between altered brain micro-structure
and function, and cognitive function in patients with end-stage renal disease (ESRD)
undergoing maintenance hemodialysis. Specially, diffusion kurtosis imaging (DKI),
the resting-state functional connectivity (FC) algorithm, and the least squares support
vector regression machine (LSSVRM) were utilized to conduct our study.
Materials and Methods
A total of 50 patients and 36 matched healthy controls were prospectively enrolled
in our study. All subjects completed the Montreal cognitive assessment scale (MoCA)
test. DKI and resting-state functional magnetic resonance imaging were measured. Relationship
between DKI parameters, FC, and MoCA scores was evaluated. LSSVRM combined with the
whale optimization algorithm (WOA) was used to predict cognitive function scores.
Results
In ESRD patients, altered DKI metrics were identified in 12 brain regions. Furthermore,
we observed changes in FC values based on regions of interest (ROIs) in nine brain
regions, involved in default mode network (DMN), frontoparietal network (FPN), and
the limbic system. Significant correlations among DKI values, FC values, and MoCA
scores were found. To some extent, altered FC showed significant correlations with
changed DKI parameters. Furthermore, optimized prediction models were applied to more
accurately predict the cognitive function associated with ESRD patients.
Conclusion
Micro-structural and functional brain changes were found in ESRD patients, which may
account for the onset of cognitive impairment in affected patients. These quantitative
parameters combined with our optimized prediction model may be helpful to establish
more reliable imaging markers to detect and monitor cognitive impairment associated
with ESRD.
Key Words
Abbreviations:
ESRD (end-stage renal disease), HC (healthy controls), rs-fMRI (resting-state functional magnetic resonance imaging), BOLD (blood-oxygen-level-dependent), DKI (diffusion kurtosis imaging), DTI (diffusion tensor imaging), FC (functional connectivity), LSSVRM (least squares support vector regression machine), WOA (whale optimization algorithm), CI (cognitive impairment), MK (mean kurtosis), AK (axial kurtosis), RK (radial kurtosis), KA (kurtosis anisotropy), MoCA (Montreal cognitive assessment scale), DMN (default mode network), FPN (frontoparietal network), CKD (chronic kidney disease)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 22, 2022
Accepted:
June 25,
2022
Received in revised form:
June 19,
2022
Received:
June 6,
2022
Identification
Copyright
© 2022 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
