title: Abnormal Intrinsic Brain Activity Patterns in Patients with End-Stage Renal Disease Undergoing Peritoneal Dialysis: A Resting-State Functional MR Imaging Study.
abstract: OBJECTIVE
  To analyze the spontaneous brain activity patterns in patients with end-stage renal disease (ESRD) undergoing peritoneal dialysis (PD) by using resting-state functional magnetic resonance (MR) imaging with an amplitude of low-frequency fluctuations (ALFF) algorithm.
  
  
  METHODS
  This study received institutional review board approval, and all subjects gave informed consent. Forty-four patients with ESRD, 24 of whom were undergoing PD (PD group; eight women; mean age, 34 years ± 8) and 20 who were not undergoing PD or hemodialysis (nondialysis group; six women; mean age, 37 years ± 9) and 24 healthy control subjects (eight women; mean age, 32 years ± 9 years) were included. All subjects underwent neuropsychologic tests, and patients with ESRD underwent laboratory testing. ALFF values were compared among the three groups. The relationship between ALFF values and clinical markers was investigated by using multiple regression analysis.
  
  
  RESULTS
  Patients in both the PD and nondialysis groups showed lower ALFF values in default mode network regions than did healthy control subjects (P < .01, false discovery rate corrected). Patients in the PD group showed lower ALFF values than did those in the nondialysis group in the left superior parietal lobe (1.51 ± 0.21 vs 2.01 ± 0.40), left inferior parietal lobe (0.99 ± 0.16 vs 1.13 ± 0.22) and left precuneus (1.45 ± 0.39 vs 1.77 ± 0.41) (P < .01, corrected with simulation software). In patients in the PD group, neuropsychologic test scores correlated with ALFF values of the middle temporal gyrus and the parietal and occipital lobe, serum urea and creatinine levels negatively correlated with ALFF in some default mode network regions, and hemoglobin positively correlated with ALFF in the bilateral precuneus, precentral, and supplementary motor areas (P < .01 corrected).
  
  
  CONCLUSIONS
  Patients with ESRD who were undergoing PD showed more severe spontaneous brain activity abnormalities that correlate with cognitive impairments than did patients who were not undergoing dialysis. Elevated serum urea, creatinine, and lowered hemoglobin levels affect spontaneous brain activity in patients with ESRD.
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Song
authors.initials: S
authors.lastname: Luo
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Rong Feng
authors.initials: RF
authors.lastname: Qi
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Ji Qiu
authors.initials: JQ
authors.lastname: Wen
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Jian Hui
authors.initials: JH
authors.lastname: Zhong
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Xiang
authors.initials: X
authors.lastname: Kong
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Xue
authors.initials: X
authors.lastname: Liang
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Qiang
authors.initials: Q
authors.lastname: Xu
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Gang
authors.initials: G
authors.lastname: Zheng
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Long Jiang
authors.initials: LJ
authors.lastname: Zhang
authors.affiliation: From the Department of Medical Imaging (S.L., R.F.Q., X.K., X.L., Q.X., G.Z., L.J.Z., G.M.L.) and National Clinical Research Center of Kidney Disease (J.Q.W., Z.Z.), Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China; Department of Biomedical Engineering and State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Zhejiang University, Hangzhou, China (J.H.Z.).
authors.forename: Guang Ming
authors.initials: GM
authors.lastname: Lu
mesh_terms: D000328:Adult; D000465:Algorithms; D001927:Brain Diseases / Q000175:diagnosis* / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests; D010530:Peritoneal Dialysis; D011446:Prospective Studies