Response Inhibition Impairment In Patients With Peritoneal Dialysis:A FMRI Study

Objective:This study use Continuous Performance Test(CPT)and blood oxygen level-dependent functional magnetic resonance imaging(BOLD-f MRI),to explore whether patients with peritoneal dialysis have response inhibition impairment and the activated brain regions.It can help to obtain neuroimaging evidence of response inhibition impairment and explore the possible mechanisms.Methods:A total of 12 patients who were on peritoneal dialysis and 12 healthy controls were enrolled in the current study.The two groups were matched for age,gender and years of education distribution.All subjects received evaluation of the Montreal cognitive assessment(Mo CA)scales,Trail Making Tests(TMT)A and B,Continuous Performance Test(CPT).Subjects were scanned using BOLD-f MRI whilst they performed the CPT.BOLD-f MRI data are analyzed with the AFNI software.The activity of response inhibition related brain regions were compared between PD group and HC group.Results:1.The result of ethology test: The Mo CA scores and memory scores were significantly decreased in the peritoneal dialysis group(PD group)than the healthy control group(HC group)(t=-3.375,P<0.05;t=-3.463,P<0.05).The time of TMT-A and TMT-B in the PD group were obviously longer than those in the HC group(t=-4.444,P<0.001;t=5.216,P<0.001).2.The result of CPT: Number of correct responses to target stimuli(1-9)were significantly lower during PD group than HC group(t=-2.922,P<0.05).The time of correct responses to target stimuli(1-9)in the PD group were significantly longer than those in the HC group(t=-2.922,P < 0.05).Number of erroneous responses to non-target stimuli(1-NOT9)were no significant statistical difference between PD group and HC group.3.The result of BOLD-f MRI: In PD group and HC group,the common activated brain region during non-target stimulation of CPT task was mainly the right dorsolateral prefrontal cortex(DLPFC).Compared with HC group,the activation in the left DLPFC,left ventrolateral prefrontal cortex,left middle frontal gyrus,left insular lobe,and bilateral thalamus was enhanced in PD group,while the activation in the right insular lobe,left superior temporal gyrus,and right parhippocampal gyrus was weakened.Conclusion:1.Abnormal activation of brain regions associated with response inhibition function in PD patients predates significant behavioral changes.2.The abnormal activities of the left DLPFC,the left ventrolateral prefrontal cortex(VLPFC),the middle frontal gyrus,the anterior insula,and the thalamus may be closely related to the impairment of response inhibition function in PD patients.