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Aberrant cortical thickness in neurologically asymptomatic patients with end-stage renal disease

Authors Dong J, Ma X, Lin W, Liu M, Fu S, Yang L, Jiang G

Received 4 April 2018

Accepted for publication 24 May 2018

Published 2 August 2018 Volume 2018:14 Pages 1929—1939

DOI https://doi.org/10.2147/NDT.S170106

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Prof. Dr. Roumen Kirov

Peer reviewer comments 3

Editor who approved publication: Professor Wai Kwong Tang


Jianwei Dong,1,* Xiaofen Ma,2,* Wuhong Lin,1 Mengchen Liu,2 Shishun Fu,2 Lihua Yang,1 Guihua Jiang2

1
School of Mathematics, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Department of Medical Imaging, Guangdong No. 2 Provincial People’s Hospital, Guangzhou, People’s Republic of China

*These authors contributed equally to this work

Purpose: The aim of this study is to investigate the morphology of cortical gray matter in patients with end-stage renal disease (ESRD) and the relationship between cortical thickness and kidney function.
Patients and methods: Three-dimensional high-resolution brain structural magnetic resonance imaging data were collected from 35 patients with ESRD (28 men, 18–61 years old) and 40 age- and gender-matched healthy controls (HCs, 32 men, 22–58 years old). Vertex-wise analysis was then performed to compare the brains of the patients with ESRD with those of HCs to identify abnormalities in the brains of the former. Multiple biochemical measures of renal metabolin, vascular risk factors, general cognitive ability, and dialysis duration were correlated with brain morphometry alterations for the patients.
Results: Patients with ESRD showed lesser cortical thickness than the HCs. The most significant cluster with decreased cortical thickness was found in the right prefrontal cortex (P<0.05, random-field theory correction). In addition, the four local peak vertices in the prefrontal cluster were lateral prefrontal cortex (Peaks 1 and 2), medial prefrontal cortex (Peak 3), and ventral prefrontal cortex (Peak 4). Significant negative correlations were observed between the cortical thicknesses of all four peak vertices and blood urea nitrogen; a negative correlation, between the cortical thickness in three of four peaks and serum creatinine; and a positive correlation, between cortical thickness in the medial prefrontal cortex (Peak 3) and hemoglobin.
Conclusion: These results provided compelling evidence for cortical abnormality of ESRD patients and suggested that kidney function may be the key factor for predicting changes of brain tissue structure.

Keywords: cortical thickness, kidney function, vertex-wise analysis, multivariate analysis, brain morphometry alterations

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