DUN DING1, PENG LI2, Ji Xin Liu2, Xue Ying Ma2, and Ming Zhang2
1XI'AN JIAO TONG UNIVERSITY, XI'AN, China, People's Republic of, 2XI'AN, China, People's Republic of
Synopsis
To investigate
the structure and function changes in the brain in uremic RLS patients using a
resting-state function magnetic resonance imaging (fMRI) paradigm, we used A
voxel-based morphometry(VBM) method and a seed-based method to find the
abnormiy in end-stage kidney disease patients. Our results suggest that the
characteristics of the connectivity changes may reflect the pathways involved
in producing uremic RLS symptoms.Sunopsis
To investigate the structure
and function changes in the brain in uremic RLS patients using a resting-state
function magnetic resonance imaging (fMRI) paradigm, we used A voxel-based
morphometry(VBM) method and a seed-based method to find the abnormiy in
end-stage kidney disease patients. Our results suggest that the characteristics
of the connectivity changes may reflect the pathways involved in producing
uremic RLS symptoms
method
29 ESRD patients on hemodialysis with
restless legs syndrome and 27 age- and gender-matched control individuals
(without renal or neurological problems) were recruited a prospective study. A
voxel-based morphometry(VBM) method was analyzed the grey matter thickness of bilateral
basal ganglia , and a seed-based method were used to explore the changes of VBM
abnormality regions by functional neruoimage software. The clinical
parameters and RLS severity were correlated analyzed. The characteristics of
uremic RLS patients were compared to those of the controls.
results
We
found that uremic RLS patients showed decreased thickness of right putamen, and
that reduced right connectivity with the right parahipocampal gyrus, bilateral
precentral gyrus, bilateral insulars, bilateral sensorimotor cortex and middle
cingulate cortices. RLS severity was positively correlated with hemodialysis duration (P<0.05) and grade of Back anxiety inventory (BDI), was
negatively correlated with blood urea nitrogen (BUN).
discussion
In our study, we observed alterations of thickness in the right putamen
among uremic RLS patents, although the potential pathophysiology of this
disease consists of hemodialysis, dopaminergic system dysfunction, brain iron
deficiency, and calcium/phosphate imbalance, which may appear in end-stage kidney
disease patients easily. And we found the connectivity reductions were located
in sensorimotor
areas, and the RLS severity was positively correlated with hemodialysis
duration, both of them indicated the lower function of sensorimotor of uremic
patients
Conclusions:
Our results suggest that the characteristics of the connectivity changes may
reflect the pathways involved in producing uremic RLS symptoms and indicate
that uremic RLS patients may have deficits in controlling and managing sensory
information, and the hemodialysis duration contrivute to RLS severity, which
may lead to bad emotion. Our study revealed that both the cerebral cortices and
mood were impaired in ESRD patients on routine hemodialysis
Acknowledgements
We thank all the patients and volunteers for participating in this study. Also, the authors arehighly grateful to the anonymous reviewers for their significant and constructive commentsand suggestions, which greatly improve the article.References
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