背景:终末期肾病(ESRD)认知障碍的病理生理机制尚不清楚,对神经活动的时间变异性及其与区域灌注的耦合研究有限。
目的:评估ESRD患者的神经活动和神经血管偶联(NVC),评估这些异常的分类性能,并探讨它们与认知功能的关系。
方法:前瞻性。
方法:33例ESRD患者,35岁,性别,和教育匹配的健康对照(HCs)。
■3.0T/3D伪连续动脉自旋标记,静息态功能磁共振成像,和3D-T1加权结构成像。
结果:评估了低频波动的动态(dfALFF)和静态(sfALFF)分数振幅和脑血流量(CBF)。确定ESRD患者和HCs的CBF-fALFF相关系数和CBF/fALFF比值。评估了他们区分ESRD患者和HCs的能力,同时评估脑小血管病(CSVD)MRI特征。所有参与者都接受了血液生化和神经心理学测试以评估认知能力下降。
方法:卡方检验,双样本t检验,Mann-WhitneyU测试,协方差分析,偏相关分析,家庭错误,错误发现率,Bonferroni校正,受试者工作特征曲线下面积(AUC)和多变量模式分析。P<0.05表示统计学意义。
结果:ESRD患者在左额下回(IFGtriang)和左颞中回的三角形部分表现出更高的dfALFF,多个脑区CBF/DFALFF比值较低,双侧颞上回(STG)CBF/sfALFF比值降低。与CBF/sfALFF比值相比,dfALFF,和sfalff,CBF/dfALFF比值(AUC=0.916)在区分ESRD患者与HC方面实现了最强大的分类性能。在ESRD患者中,CBF/fALFF比值降低与更严重的肾功能损害相关,CSVD负担增加,和认知能力下降(0.4<|r|<0.6)。
结论:ESRD患者表现出动态脑活动异常和NVC受损,具有动态功能,显示出较高的判别能力,CBF/dfALFF比率显示出强大的分类性能。
方法:1技术效果:第一阶段。
BACKGROUND: Pathophysiological mechanisms underlying cognitive impairment in end-stage renal disease (ESRD) remain unclear, with limited studies on the temporal variability of neural activity and its coupling with regional perfusion.
OBJECTIVE: To assess neural activity and neurovascular coupling (NVC) in ESRD patients, evaluate the classification performance of these abnormalities, and explore their relationships with cognitive function.
METHODS: Prospective.
METHODS: Exactly 33 ESRD patients and 35 age, sex, and education matched healthy controls (HCs).
UNASSIGNED: The 3.0T/3D pseudo-continuous arterial spin labeling, resting-state functional MRI, and 3D-T1 weighted structural imaging.
RESULTS: Dynamic (dfALFF) and static (sfALFF) fractional amplitude of low-frequency fluctuations and cerebral blood flow (CBF) were assessed. CBF-fALFF correlation coefficients and CBF/fALFF ratio were determined for ESRD patients and HCs. Their ability to distinguish ESRD patients from HCs was evaluated, alongside assessment of cerebral small vessel disease (CSVD) MRI features. All participants underwent blood biochemical and neuropsychological tests to evaluate cognitive decline.
METHODS: Chi-squared test, two-sample t-test, Mann-Whitney U tests, covariance analysis, partial correlation analysis, family-wise error, false discovery rate, Bonferroni correction, area under the receiver operating characteristic curve (AUC) and multivariate pattern analysis. P < 0.05 denoted statistical significance.
RESULTS: ESRD patients exhibited higher dfALFF in triangular part of left inferior frontal gyrus (IFGtriang) and left middle temporal gyrus, lower CBF/dfALFF ratio in multiple brain regions, and decreased CBF/sfALFF ratio in bilateral superior temporal gyrus (STG). Compared with CBF/sfALFF ratio, dfALFF, and sfALFF, CBF/dfALFF ratio (AUC = 0.916) achieved the most powerful classification performance in distinguishing ESRD patients from HCs. In ESRD patients, decreased CBF/fALFF ratio correlated with more severe renal impairment, increased CSVD burden, and cognitive decline (0.4 < |r| < 0.6).
CONCLUSIONS: ESRD patients exhibited abnormal dynamic brain activity and impaired NVC, with dynamic features demonstrating superior discriminative capacity and CBF/dfALFF ratio showing powerful classification performance.
METHODS: 1 TECHNICAL EFFICACY: Stage 1.