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

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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.

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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

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Acknowledgments

This work was supported by the grants from the Natural Scientific Foundation of China [Grant NoS. 30700194, 81322020, and 81230032 for Long Jiang Zhang; Grant No. 81101039 fro Gang Zheng] and China Postdoctoral Science Foundation of Jiangsu Province (Grant No. 100283C for Gang Zheng).

Disclosure of Conflicts of Interest

None of the authors has any conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Medical Imaging, Jinling Hospital, Medical School of Nanjing University, 305 Zhongshan East Road, Xuanwu District, Nanjing, Jiangsu Province, 210002, China

    Long Jiang Zhang, Ling Ni, Xue Liang, Gang Zheng & Guang Ming Lu

  2. Department of Nephrology, Jinling Hospital, Clinical School of Medical College, Nanjing University, Nanjing, 210002, China

    Jiqiu Wen

  3. Department of Imaging Sciences, University of Rochester School of Medicine and Dentistry, Box 648, 601 Elmwood Avenue, Rochester, NY, 14642-8648, USA

    Jianhui Zhong

Authors
  1. Long Jiang Zhang
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  2. Jiqiu Wen
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  3. Ling Ni
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  4. Jianhui Zhong
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  5. Xue Liang
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  6. Gang Zheng
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  7. Guang Ming Lu
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Corresponding authors

Correspondence to Long Jiang Zhang or Guang Ming Lu.

Additional information

Drs. Zhang, Wen, and Ni had the equal contribution to this work.

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Zhang, L.J., Wen, J., Ni, L. et al. Predominant gray matter volume loss in patients with end-stage renal disease: a voxel-based morphometry study. Metab Brain Dis 28, 647–654 (2013). https://doi.org/10.1007/s11011-013-9438-7

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  • DOI: https://doi.org/10.1007/s11011-013-9438-7

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