Metabolic Brain Disease

, Volume 33, Issue 5, pp 1471–1481 | Cite as

Altered amygdala-related structural covariance and resting-state functional connectivity in end-stage renal disease patients

  • Anmao Li
  • Junya Mu
  • Mingxia Huang
  • Zengjun Zhang
  • Jixin LiuEmail author
  • Ming ZhangEmail author
Original Article


Depression and cognitive control deficits were frequently reported in concurrent end-stage renal disease (ESRD) patients. Neuroimaging studies indicated depression could be a risk factor for cognitive control deficits, and amygdala-related circuitry may play a critical role in this abnormal interaction. To investigate the potential relationship between depressive symptoms and cognitive control reduction in ESRD patients, T1-weighted and resting fMRI images were obtained in 29 ESRD patients and 29 healthy controls. Voxel-based morphometry (VBM), structural covariance (SC) analysis based on grey matter volume (GMV), and functional connectivity (FC) analysis were adopted. All subjects performed the Beck Depression Inventory (BDI) assessment and Stroop test. The patients also underwent blood biochemistry tests (urea, creatinine, phosphate, Ca2+, hematocrit, cystatin, hemoglobin). Compared with controls, GMV reductions were found mainly in the anterior cingulate cortex (ACC) and bilateral amygdala, and decreased SC was found between the amygdala and ACC in ESRD patients. This indicated that structural changes in the amygdala may be related to the GMV alterations in the ACC. Additionally, decreased FC between the amygdala and ACC was revealed in ESRD patients. Negative correlation was found between the FC of the amygdala-ACC and reaction delay during the Stroop test, but this correlation disappeared after controlling BDI. Stepwise regression analysis showed that the low level of hemoglobin was contributed to the reduced FC of the amygdala-ACC in ESRD patients. Our results demonstrated the abnormal interaction between depressive mood and cognitive control deficits in ESRD patients.


End-stage renal disease Depressive mood Cognitive control Structural covariance Resting-state functional connectivity 



This work was supported by the National Natural Science Foundation of China under Grant Nos. 81471737, 81473603, 81571640, 81501543, 81401478, 81571751, and 81470816; and the Natural Science Foundation of Shaanxi Province of China under Grant Nos. 2017ZDJC-13.

Compliance with ethical standards

Conflict of interest

Anmao Li, Mingxia Huang, Zengjun Zhang, Junya Mu, Jixin Liu and Ming Zhang declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Ethical statements

Informed consent was obtained from all individual participants included in the study.


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Authors and Affiliations

  1. 1.Department of Medical ImagingFirst Affiliated Hospital of Xi’an Jiaotong UniversityXi’anPeople’s Republic of China
  2. 2.Xi’an Children’s HospitalXi’anPeople’s Republic of China
  3. 3.Center for Brain Imaging, School of Life Science and TechnologyXidian UniversityXi’anPeople’s Republic of China
  4. 4.Engineering Research Center of Molecular and Neuro ImagingMinistry of EducationXi’anPeople’s Republic of China

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