Altered resting-state cerebellar-cerebral functional connectivity in patients with end-stage renal disease

Abstract

Background

End-stage renal disease (ESRD) patients have functional and structural brain abnormalities. The cerebellum also showed varying degrees of damage. However, no studies on cerebellar-cerebral functional connectivity (FC) have been conducted in ESRD patients. This study aimed to investigate the changes in cerebellar-cerebral FC in ESRD patients and its relationship with neuropsychological and clinical indexes.

Methods

Resting-state functional magnetic resonance imaging and neuropsychological assessment were performed on 37 ESRD patients and 35 control subjects. Seed-based FC analysis was performed to investigate inter-group differences in cerebellar-cerebral FC. In addition, the relations of altered FC with the neuropsychological function and clinical indicators were analyzed in ERSD patients.

Results

ESRD patients exhibited alterations in cerebellar-cerebral FC involving the executive control network, default mode network, and affective-limbic network compared to control subjects (False discovery rate-corrected, p < 0.05). The altered cerebellar-cerebral FC was associated with the Montreal Cognitive Assessment Scale score (p < 0.05), and correlated with serum creatinine and uric acid levels within the ESRD group (p < 0.05).

Conclusions

The study indicates that cerebellar-cerebral FC is involved in the neural substrates of cognitive impairment in ESRD patients. The findings may provide clinically relevant new neuroimaging biomarkers for the neuropathological mechanisms underlying cognitive impairment of ESRD.

Keywords:

• End-stage renal disease
• cerebellum
• resting-state fMRI
• functional connectivity
• cognitive impairment

Acknowledgments

We also would like to thank Freescience for English language editing.

Author contributions

JF contributed to experimental design, data acquisition, data handling, and data interpretation, and wrote the article. FZ, JLZ, YRL and YYM were involved in clinical evaluation and data acquisition. HBW and XMQ contributed to the study design, data interpretation and revised the manuscript.

Ethical approval

This study involving human participants was reviewed and approved by the biomedical ethics committee of Anhui Medical University.

Patient consent

All participants provided their written informed consent to participate in this study.

Consent to publish

The manuscript has been read and approved for submission by all (co-)authors.

Disclosure statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors.

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research was supported by Natural Science Foundation of Anhui Province (No. 1908085MH245) and Natural Science Research Project of Anhui Universities (No. KJ2018A0493)