与决策相关的大脑网络的微观结构和功能连接性变化在末期脏病患者中,这些患者正在接受腹腔透析
Jingjing Yin1,2, Dongxue Luo3, Shuhua Ma1,2
1Department of Radiology, The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
Kidney research and clinical practice
|January 24, 2025
概括
在末期脏病 (ESKD) 患者的腹腔透析 (PD) 改变了决策领域的大脑结构和功能,影响了认知功能. 然而,PD可能与预透析相比保留认知功能,这表明神经成像.
科学领域:
- 神经科学是一个神经科学.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 放射学 放射学是一门学科.
背景情况:
- 末期病 (ESKD) 显著影响患者的健康.
- 腹腔透析 (PD) 是一种常见的ESKD治疗方法.
- 在PD患者的认知功能和大脑变化需要进一步调查.
研究的目的:
- 探索与PD患者决策相关的大脑微观结构,功能和连接性的变化.
- 评估这些大脑变化与认知功能之间的相关性.
- 检查PD对这些神经和认知方面的影响.
主要方法:
- 招募了30名患有PD的ESKD患者,20名预透析CKD5期患者和30名健康对照 (HC).
- 进行了神经心理测试,决策行为测试,基于voxel的形态测量和功能性MRI.
- 分析了与决策相关领域的结构和功能大脑变化.
主要成果:
- 与HC相比,PD患者在关键决策领域 (vmPFC,OFC,ACC) 的功能激活和灰质体积减少.
- 在与vmPFC和ACC连接的默认模式网络 (DMN) 和突出网络 (SAN) 中观察到功能连接性下降.
- 与预透析患者相比,PD患者的ACC,vmPFC和insula激活率增加,尽管在爱荷华州博任务 (IGT) 上的认知表现类似.
- 大脑结构/功能变化与IGT和认知得分相关;OFC激活与肌素,囊素和PTH水平相反相关.
结论:
- 腹腔透析改变与决策相关的大脑电路 (vmPFC-OFC-ACC) 和网络集成 (DMN,SAN),与认知和临床因素相关.
- PD可能提供与预透析相比的可比性认知保护和疾病进展管理.
- 多模式神经成像在ESKD认知障碍的早期诊断和干预方面有助于.
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