VBM And SBM Study On Cerebral Structure Changes Of End-stage Renal Disease

Objective The patients with end-stage renal disease(ESRD)often change in cerebral structure and cognition.To investigate the correlation between the cerebral gray-matter volume,cortical thickness changes and cognition,course of the disease,biochemical indexes,cerebral structure of ESRD was valuated by using VBM and SBM.Methods 47 patients with ESRD and 46 normal volunteers underwent MRI structure scanning and neuropsychology tests.The Matlab software and DPABI,SPM 12,CAT12 were used to preprocess the cerebral structure data,Independent sample t-test was used for cerebral volume data and cortical thickness data of two groups,and cerebral regions of difference were obtained(P<0.05,FWE corrected).Pearson correlations between volume and cortical thickness of cerebral regions of difference and Mo CA,MMSE,TMT-A,course of the disease,biochemical indexes were conducted by using SPSS(P<0.05).Results1.The analysis results of neuropsychological assessment,clinical data and biochemical index1)The duration of disease was negatively correlated with executive ability,Mo CA and delayed memory score;2)The duration of dialysis was negatively correlated with MoCA,executive ability,attention,and MMSE;3)Serum iron was positively correlated with attention,abstract score,Mo CA,negatively correlated with TMT-A.2.The analysis results of cerebral gray-matter volume1)Gray-matter volume of ESRD group decreased in the L-CAU,L-PHG,L-ACC,left transverse temporal gyrus,L-MFG,L-AINS,L-MCC,R-MCC,right temporal pole and R-pre CG(all P<0.05,FWE corrected).2)The volume of the L-ACC,L-AINS was positively correlated with MoCA score;The volume of the L-AINS was positively correlated with executive ability score;The volume of the L-ACC,L-AINS,L-MCC was positively correlated with attention score;The volume of the L-ACC,R-pre CG was positively correlated with language score;The volume of the L-ACC was positively correlated with abstract score;The volume of the L-ACC,L-MCC was negatively correlated with TMT-A score;3)The volume of the right temporal pole,L-PHG was negatively correlated with duration of disease;4)The volume of the L-MFG was negatively correlated with CRP;5)The volume of the L-ACC,L-PHG,left transverse temporal gyrus,right temporal pole and R-pre CG was positively correlated with Serum iron;3.The analysis results of cerebral cortical thickness1)Gray-matter cortical thickness of ESRD group decreased in left cuneus,posterior cingulate and right peri calcarine,fusiform,PHG,transverse temporal,po CG,lateral occipital,inferior parietal,supramarginal and bilateral superior temporal,lingual,precuneus,superior frontal,pars opercularis,rostral middle frontal,LOFC(all P<0.05,FWE corrected).2)The cortical thickness of the L-LOFC was negatively correlated with delayed memory score;3)The cortical thickness of the R-PHG,right pars opercularis and bilateral rostral middle frontal was positively correlated with albumin;The cortical thickness of the right fusiform,right transverse temporal was negatively correlated with urea;The cortical thickness of the left lingual,left precuneus was positively correlated with CRP;The cortical thickness of the right lateral occipital was positively correlated with serum iron.Conclusion1)The cognitive functions of ESRD patients are impaired;2)The volume atrophy of multiple cerebral regions,including L-ACC,L-AINS,L-MCC,R-pre CG,L-PHG,L-MFG,left transverse temporal gyrus and right temporal pole,are related to cognition and related fields,duration of disease,serum iron and CRP levels in ESRD patients.3)The cortical thickness atrophy of multiple cerebral regions,including L-LOFC,left lingual,left precuneus,R-PHG,right pars opercularis,right fusiform,right transverse temporal,right lateral occipital,and bilateral rostral middle frontal,are related to delayed memory,Alb,CRP,serum iron and urea levels in ESRD patients.