Purpose

To investigate cerebral amplitude of low-frequency fluctuations (ALFF) changes during a single hemodialysis (HD) in end-stage renal disease (ESRD) patients who need maintenance HD.

Materials and Methods

A total of 24 patients and 27 healthy subjects were included. The patients underwent neuropsychological tests and took twice resting-state fMRI (rs-fMRI) (before and after HD). Healthy group had one rs-fMRI. The zALFF based on rs-fMRI was calculated. Paired t and independent t test was applied to compare zALFF among groups. The associations between zALFF and duration of HD, ultrafiltration volume, and neuropsychological tests was calculated by partial correlation.

Results

Compared to healthy group, patients before HD showed significant worse performances on digit symbol test (DST) and serial dotting test (SDT). Patients after HD performed DST better than before HD. The patients after HD showed higher zALFF in left putamen than before HD. Multiple regions of both HD groups showed significant lower zALFF than healthy group. The zALFF of left putamen of patients after HD was significant negative correlated with the ultrafiltration volume (R = −0.679). The zALFF in patients before HD exhibited significantly positive or negative correlations with DST and SDT in multiple regions. The zALFF of patients after HD significantly negative correlated with DST in right temporal, positive and negative correlated with ultrafiltration volume in right frontal, left putamen respectively.

Conclusion

ESRD patients showed changed spontaneous brain activity and cognitive impairments. After a single HD session, patients performed better in neuropsychological test, and spontaneous brain activity changed in left putamen. Ultrafiltration volume might be associated with activity of left putamen.

中文翻译：

---

终末期肾病患者在单次透析期间的即时异常内在脑活动模式：静息状态功能 MRI 研究。

目的

研究需要维持 HD 的终末期肾病 (ESRD) 患者在单次血液透析 (HD) 期间低频波动 (ALFF) 变化的脑振幅。

材料和方法

共包括 24 名患者和 27 名健康受试者。患者接受了神经心理学测试，并进行了两次静息态 fMRI (rs-fMRI)（HD 前后）。健康组有一个 rs-fMRI。计算基于 rs-fMRI 的 zALFF。配对 t 和独立 t 检验用于比较组间的 zALFF。zALFF 与 HD 持续时间、超滤量和神经心理学测试之间的关联通过偏相关计算。

结果

与健康组相比，HD前患者在数字符号测试（DST）和串行点测试（SDT）上表现出明显较差的表现。HD 后患者的 DST 比 HD 前更好。HD 后患者左壳核的 zALFF 高于 HD 前。两个 HD 组的多个区域的 zALFF 均显着低于健康组。HD后患者左壳核的zALFF与超滤量呈显着负相关（R = -0.679）。HD前患者的zALFF与多个区域的DST和SDT呈显着正相关或负相关。HD后患者的zALFF与右侧颞叶DST显着负相关，分别与右侧额叶、左侧壳核的超滤量呈正负相关。

结论

ESRD 患者表现出改变的自发大脑活动和认知障碍。单次 HD 治疗后，患者在神经心理学测试中表现更好，左壳核的自发大脑活动发生了变化。超滤量可能与左壳核的活动有关。