Evaluation of depressive disorder in end-stage renal disease patients by proton diffusion tensor imaging

This study aimed to evaluate the depressive disorder in the end-stage renal disease (ESRD) patients by proton diffusion tensor imaging (DTI). Fifty-four ESRD patients and 30 healthy subjects were enrolled and received brain DTI. ESRD patients were further divided into non-depression group (nD-ESRD, n=28) and depression group (D-ESRD, n=26). The DTI parameters were collected, and the changes in the white matter fibers microstructure were compared among groups. The correlations of fractional anisotropy (FA) value and laboratory findings with Hamilton Depression Scale (HAMD) 17 score were further evaluated in the D-ESRD group. Results showed that there were significant differences in the course of disease and HAMD17 score (P < 0.05) among three groups. There were significant differences in the serum Ca2+ (t = 3.976, P = 0.032), creatinine (t = 2.024, P = 0.049) and urea nitrogen (t = 2.930, P = 0.037) among three groups. Marked differences were noted in the DTI values of multiple brain regions among three groups. In the D-ESRD group, the FA values of left frontal white matter (r = −0.672, P = 0.003) and left anterior limb of internal capsule (r = −0.476, P = 0.023) were related to the HAMD17 score, and the serum Ca2+ (r = 0.581, P = 0.031) and urea nitrogen (r = 0.796, P = 0.003) were associated with the HAMD17 score. Thus, DTI parameters (especially the change in FA value) are expected to be an auxiliary diagnostic tool to objectively evaluate depression in ESRD patients, which is helpful for the early treatment of depression.