Metabolic Brain Disease

, Volume 28, Issue 4, pp 647–654

Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study

Authors

    • Department of Medical Imaging, Jinling HospitalMedical School of Nanjing University
  • Jiqiu Wen
    • Department of Nephrology, Jinling Hospital, Clinical School of Medical CollegeNanjing University
  • Ling Ni
    • Department of Medical Imaging, Jinling HospitalMedical School of Nanjing University
  • Jianhui Zhong
    • Department of Imaging SciencesUniversity of Rochester School of Medicine and Dentistry
  • Xue Liang
    • Department of Medical Imaging, Jinling HospitalMedical School of Nanjing University
  • Gang Zheng
    • Department of Medical Imaging, Jinling HospitalMedical School of Nanjing University
    • Department of Medical Imaging, Jinling HospitalMedical School of Nanjing University
Research Paper

DOI: 10.1007/s11011-013-9438-7

Cite this article as:
Zhang, L.J., Wen, J., Ni, L. et al. Metab Brain Dis (2013) 28: 647. doi:10.1007/s11011-013-9438-7

Abstract

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 (All P < 0.05, AlphaSim correction). NP scores correlated with some decreased gray matter volume in ESRD patients (All P < 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.

Keywords

End-stage renal diseaseVoxel-based morphometryMagnetic resonance imaging

Abbreviations

DST

Digit symbol test

ESRD

End-stage renal disease

GM

Gray matter

MRI

Magnetic resonance imaging

NCT-A

Number connecting-A

VBM

Voxel-based morphometry

WM

White matter

Supplementary material

11011_2013_9438_MOESM1_ESM.doc (173 kb)
ESM 1(DOC 173 kb)

Copyright information

© Springer Science+Business Media New York 2013