维持性血液透析终末期肾病患者丘脑功能连接异常与记忆减退的相关性研究

Correlation between abnormal thalamic functional connectivity and memory decline in patients with end-stage renal disease undergoing maintenance hemodialysis

目的探索维持性血液透析终末期肾病(end-stage renal disease,ESRD)患者丘脑功能连接(functional connectivity,FC)异常与记忆减退的相关性。方法对22例ESRD患者(ESRD组)和28例年龄、性别、受教育程度相匹配的健康对照(HC组)行听觉词语学习测试-华山版(AVLT-H)评估记忆功能,随后采集静息态功能磁共振成像(rs-fMRI)数据并行基于丘脑的全脑FC分析比较两组间丘脑的FC差异,最后进行Pearson和Spearman相关性分析。结果与HC组相比,ESRD组患者IR-S(P=0.002)、SR-S(P<0.001)、LR-S(P=0.005)得分显著降低;同时,ESRD组右侧丘脑与左侧额上回眶部、左侧顶上小叶、右侧枕上回、右侧楔前叶及右侧额中回的FC降低(P<0.05,TFCE校正),ESRD组左侧丘脑与左侧直回、左侧顶上小叶及右侧顶上小叶的FC降低(P<0.05,TFCE校正),ESRD组左侧丘脑与左侧直回的FC值与IR-S(r=-0.499)、SR-S(r=-0.458)及LR-S(r=-0.455)呈显著负相关(P均<0.05)。结论维持性血液透析ESRD患者存在记忆功能减退,且与左侧丘脑和左侧直回的FC异常密切相关,可以为观察ESRD患者的记忆功能障碍提供影像学标记。

Objective To explore the correlation between abnormal thalamic functional connectivity(FC) and memory loss in maintenance hemodialysis patients with end-stage renal disease(ESRD).Methods An auditory verbal learning test(AVLT-H) was conducted on 22 patients with ESRD and 28 age-,sex-,and education-matched healthy controls(HC) to evaluate memory function.After that,resting-state functional magnetic resonance imaging(rs-fMRI) data were gathered,and a whole-brain FC analysis centered on the thalamus was executed to discern variations in thalamic FC between the two groups.Finally,Pearson and Spearman correlation analyses were carried out.Results Compared to the HC group,the ESRD group exhibited notably lower scores in IR-S(P=0.002),SR-S(P<0.001),and LR-S(P=0.005).Concurrently,the ESRD group demonstrated diminished FC of the right thalamus with the left superior frontal gyrus,the left parietal lobule,the right suproccipital gyrus,the right anterior cuneus,and the right middle frontal gyrus(P<0.05,TFCE correction).Additionally,reduced FC were observed between the left thalamus and the left gyrus rectus,the left parietal lobule,and the right parietal lobule in the ESRD group(P<0.05,TFCE correction).Moreover,the FC values between the left thalamus and the left gyrus rectus in the ESRD group displayed significant negative correlations with IR-S(r=-0.499),SR-S(r=-0.458),and LR-S(r=-0.455)(all P<0.05).Conclusion Memory impairment is evident in ESRD patients undergoing maintenance hemodialysis,and it appears to be intricately linked to anomalous FC within the left thalamus and the left gyrus rectus.These findings offer potential imaging markers for monitoring memory dysfunction in individuals with ESRD.