分子影像学杂志2026，Vol.49Issue(2)：205-210,6.DOI:10.12122/j.issn.1674-4500.2026.02.10
首次透析前终末期肾病患者脑功能改变与认知功能障碍的相关性
Altered functional connectivity and its association with cognitive impairment in pre-dialysis end-stage renal disease
摘要
Abstract
Objective To investigate alterations in brain function in patients with end-stage renal disease(ESRD)prior to their first dialysis using the fractional amplitude of low-frequency fluctuation(fALFF)and functional connectivity(FC)analyses of resting-state functional magnetic resonance imaging(rs-fMRI),and to further analyze the correlation between these brain functional changes and cognitive scores.Methods Forty-eight ESRD patients(ESRD group)scheduled for renal replacement therapy were recruited from our hospital from April 2023 to March 2025,along with 44 matched healthy volunteers(control group).All participants underwent rs-fMRI scanning and cognitive assessment using the Montreal Cognitive Assessment(MoCA).fALFF differences between the two groups were compared.Brain regions showing significant differences were used as regions of interest(ROIs)for subsequent FC analysis to investigate the functional integration patterns between these ROIs and whole-brain voxels.After controlling for the effects of age,gender,and education level,partial correlation analyses were conducted between the fALFF values/FC values of the identified brain regions and the MoCA scores.Results The MoCA scores were significantly lower in the ESRD group compared to the control group(P<0.001).Compared with controls,ESRD patients showed decreased fALFF values in PCUN.R(t=-5.445,Cluster-level FWE correction,P<0.05,with clusters comprising a minimum of 67 voxels).FC analysis revealed that ESRD patients had decreased FC between PCUN.R and SMG.R(P<0.001,uncorrected)as well as DCG.R(P<0.001,uncorrected),but increased FC between PCUN.R and MFG.R(P<0.001,uncorrected).After controlling for gender,age,and education level,the FC value between PCUN.R and SMG.R showed a significant positive correlation with the MoCA score of ESRD patients(r=0.346,P<0.05,FDR-corrected,k=4).Conclusion Patients with ESRD exhibit altered spontaneous brain activity and functional connectivity within the default mode network(DMN)at rest,which are closely associated with cognitive function.These findings provide novel neuroimaging evidence for understanding the neuropathophysiological mechanisms underlying cognitive impairment associated with ESRD prior to the initiation of dialysis.关键词
终末期肾病/静息态功能磁共振成像/比例低频波动幅度/功能连接/认知功能障碍Key words
end-stage renal disease/resting-state functional MRI/fractional amplitude of low frequency fluctuation/functional connectivity/cognitive dysfunction引用本文复制引用
张盼,张桂荣,张明,丁墩..首次透析前终末期肾病患者脑功能改变与认知功能障碍的相关性[J].分子影像学杂志,2026,49(2):205-210,6.基金项目
陕西省自然科学基础研究一般项目(青年项目)(2022JQ-900) （青年项目）
