Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study
Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study
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终末期肾病患者的主要灰质体积损失：基于体素的形态测量研究
DOI：
10.1007/s11011-013-9438-7
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发表时间：
2013-12-01
影响因子：
3.6
通讯作者：
Lu, Guang Ming
中科院分区：
文献类型：
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作者：
Zhang, Long Jiang;Wen, Jiqiu;Lu, Guang Ming
采用基于体素的形态计量学（VBM）研究终末期肾病（ESRD）患者的脑体积变化模式，并与临床和神经心理学（NP）测试进行相关性分析。本研究招募了57例常规磁共振成像无解剖学异常的ESRD患者[24例NP评分异常的患者，16例男性，39 ± 12岁; 33例NP评分正常的患者，23例男性，35 ± 9.7岁]和22例年龄和性别匹配的健康对照（14例男性，36 ± 10.1岁）。VBM分析结果在3组（对照组、轻微肾性脑病组、非肾性脑病组）中进行方差分析。采用多元线性回归分析探讨血清尿素、肌酐和透析时间对终末期肾病患者脑体积的影响。对ESRD患者的NP评分与脑体积进行相关性分析。与健康对照组相比，终末期肾病患者表现为弥漫性灰质体积减少，在脑病存在时进一步减少。多元线性回归结果显示，血清尿素与许多区域的灰质体积变化呈负相关，而透析持续时间与某些白色体积变化呈负相关（AllP< 0.05，AlphaSim校正）。在ESRD患者中，NP评分与一些灰质体积减少相关（AllP< 0.05，AlphaSim校正）。在ESRD患者中，未发现白色物质体积与任何NP测试评分之间存在相关性。这项研究发现ESRD患者的灰质体积主要减少，这与神经认知功能障碍有关。血清尿素水平可能是终末期肾病患者脑灰质减少的危险因素。
To investigate the pattern of brain volume changes in patients with end-stage renal disease (ESRD) using voxel-based morphometry (VBM) and correlation with clinical and neuropsychological (NP) tests. Fifty seven ESRD patients with no anatomical abnormalities in conventional magnetic resonance imaging [24 patients with abnormal NP scores, 16 male, 39 ± 12 years; 33 patients with normal NP scores, 23 male, 35 ± 9.7 years] and 22 age- and gender-matched healthy controls (14 male, 36 ± 10.1 years) were recruited in this study. Results from VBM analysis were analyzed with ANOVA test among 3 groups (controls, minimal nephro-encephalopathy group, non-nephro-encephalopathy group). Multiple linear regression analysis was used to investigate the effect of serum urea and creatinine, and dialysis duration on the brain volumes in ESRD patients. Correlation analysis was performed to investigate the association between NP scores with the brain volumes in ESRD patients. Compared with healthy controls, ESRD patients showed diffusely decreased gray matter volume that further decreased in the presence of encephalopathy. Multiple linear regression results showed that serum urea was negatively associated with changes in gray matter volume in many regions, while dialysis duration was negatively associated with some white matter volume changes (AllP< 0.05, AlphaSim correction). NP scores correlated with some decreased gray matter volume in ESRD patients (AllP< 0.05, AlphaSim correction). No correlation was found between white matter volume and any NP test scores in ESRD patients. This study found predominantly decreased gray matter volume in ESRD patients, which was associated with neurocognitive dysfunction. Serum urea level may be a risk factor for decreased gray matter in ESRD patients.