Altered Brain Functional Connectivity of resting-state networks in Neurologically Asymptomatic Patients with End-Stage Renal Disease Undergoing Maintenance Hemodialysis

Abstract Purpose: To investigate changes in the functional connectivity (FC) of neurologically asymptomatic patients with end-stage renal disease (ESRD) on haemodialysis (HD) and determine the relationship between these changes and clinical variables. Methods: Resting-state functional magnetic resonance imaging was performed in 36 neurologically asymptomatic patients with ESRD on HD (ESHD) and 31 healthy control subjects. Using independent component analysis, abnormal resting-state networks and FC regions were identified in the two groups. Partial correlation analysis was performed between abnormal FC regions and clinical variables. Results: The ESHD group exhibited abnormal FC in multiple regions of three RSNs, including the posterior default mode network (DMN), attention network, and external visual network (VN). Significant correlations were found between the FC values of multiple brain regions (the right supramarginal gyrus, the left angular gyrus, and the left middle occipital gyrus) of the DMN or VN and the neurocognitive scale scores in the ESHD group. Additionally, the FC value of the right median cingulate gyrus was negatively correlated with the serum calcium level. Conclusion: Our study found that the ESHD group exhibited multiple abnormal FC regions in three RSNs involved in visual–spatial processing, short-term memory, language, attention and executive function; these findings are consistent with the characteristics of cognitive impairment during the HD process. Our findings provided both empirical and complementary evidence indicating that FC changes may be associated with the underlying clinical symptoms of patients with ESHD.