Investigating Brain Functional Connectivity and Its Correlation With Cognitive Dysfunction in Chronic Kidney Disease...

This study aimed to assess the brain functional connectivity and its association with cognitive function in patients with chronic kidney disease (CKD) using resting-state functional magnetic resonance imaging (rs-fMRI).

A total of 64 CKD patients were enrolled and divided into two groups based on their dependence on dialysis: dialysis-dependent CKD (DD-CKD) group (n = 38) and non-dialysis-dependent CKD (NDD-CKD) group (n = 26). A total of 43 healthy controls (NC) were also recruited and matched for age and sex. Cognitive function was evaluated using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). MRI scans were conducted on a 3.0T Magnetom Skyra scanner equipped with a 32-channel phased array head coil. Data analysis was performed using the Data Processing Assistant for Resting-State fMRI (DPARSF) and Statistical Parametric Mapping (SPM) software.

Cognitive scores (MMSE and MoCA) were significantly lower in both CKD groups compared to healthy controls (p < 0.001), with DD-CKD patients exhibiting worse cognitive performance than NDD-CKD patients (p < 0.05). Laboratory parameters also differed: compared with DD-CKD, NDD-CKD patients had significantly lower levels of protein, creatinine, calcium, and phosphate (all p < 0.05). Network-based statistical analysis revealed reduced functional connectivity in both CKD groups relative to controls (p < 0.05). NDD-CKD patients showed disruptions mainly in the frontal-insular and occipital networks, whereas DD-CKD patients exhibited more extensive alterations involving frontoparietal, cingulate, and visual regions. Correlation analysis further showed that connectivity reductions in key regions-including the dorsolateral prefrontal cortex and parietal association areas-were negatively associated with renal function indicators such as serum creatinine and urea nitrogen (p < 0.05).

Resting-state fMRI effectively reflects alterations in brain functional connectivity in CKD patients and is associated with cognitive performance. Notably, DD-CKD patients showed more extensive network disruptions and more severe cognitive impairment.