The study on cerebral variations and cognitive function in male patients with hyperuricemia using amide proton...

Hyperuricemia is a significant health concern, but its link to cognitive function remains unclear, with limited neuroimaging evidence. This cross-sectional study used amide proton transfer (APT) imaging to investigate brain variations in male hyperuricemic patients (HUA), including those with gout, and evaluate their correlations with cognition.

Twenty-five male patients with hyperuricemia (14 asymptomatic and 11 with gout history) and 25 healthy controls (HC) were prospectively recruited. All participants underwent serum uric acid (SUA) testing, cognitive assessments [Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE)], and 3T magnetic resonance imaging (MRI) including APT-weighted imaging with B0 correction. APT-weighted (APTw) values (MTRasym at 3.5 ppm) were quantified in 21 brain regions using a standardized, blinded protocol. Group comparisons (independent t-tests) and partial correlation analyses [controlling for age, education, body mass index (BMI), and SUA] were performed with false discovery rate (FDR) correction.

Significant differences were observed in SUA levels (HUA vs. HC: 521.52±87.16 vs. 345.48±35.78 µmol/L, P<0.001), MMSE (27.08±1.19 vs. 28.68±0.69, P<0.001), and MoCA scores (27.04±1.48 vs. 28.16±0.90, P=0.003) between the HUA and HC groups. APTw values were significantly elevated in HUA patients across 18 of 21 examined brain regions compared to HC (FDR-corrected q<0.05). No statistically significant differences in APTw values were found between asymptomatic HUA (aHUA) and gout-history HUA (gHUA) subgroups after correction. After covariate adjustment, lower APTw values in the left hippocampus (r=-0.355, q=0.035) and bilateral caudate nuclei (left: r=-0.470, q=0.007; right: r=-0.442, q=0.021) were specifically correlated with lower MMSE scores.

APT-MRI detected widespread alterations in APTw signal across multiple brain regions in HUA. These alterations, particularly in the left hippocampus and bilateral caudate nuclei, were associated with poorer cognitive performance on the MMSE, suggesting a potential neuroimaging biomarker for hyperuricemia-related cognitive changes.