Abnormal brain activity patterns during spatial working memory task in patients with end-stage renal disease on maintena
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ORIGINAL RESEARCH
Abnormal brain activity patterns during spatial working memory task in patients with end-stage renal disease on maintenance hemodialysis: a fMRI study Jinzhuang Huang 1,2,3 & Lei Xie 1,2,3 & Ruiwei Guo 1,2,3 & Jinhong Wang 4 & Jinquan Lin 1 & Zongbo Sun 1,2,3 & Shouxing Duan 5 & Zhirong Lin 1 & Hui Li 6 & Shuhua Ma 1,2,3
# The Author(s) 2020
Abstract Hemodialysis (HD) is associated with cognitive impairment in patients with end-stage renal disease (ESRD). However, the neural mechanism of spatial working memory (SWM) impairment in HD-ESRD patients remains unclear. We investigated the abnormal alterations in SWM-associated brain activity patterns in HD-ESRD patients using blood oxygen level-dependent functional magnetic resonance imaging (BOLD-fMRI) technique during n-back tasks. Twenty-two HD-ESRD patients and 22 well-matched controls underwent an fMRI scan while undergoing a three-load n-back tasks with different difficulty levels. Cognitive and mental states were assessed using a battery of neuropsychologic tests. The HD-ESRD patients exhibited worse memory abilities than controls. Compared with the control group, the HD-ESRD patient group showed lower accuracy and longer response time under the n-back tasks, especially in the 2-back task. The patterns of brain activation changed under different working memory loads in the HD-ESRD patients, showing decreased activity in the right medial frontal gyrus and inferior frontal gyrus under 0-back and 1-back task, while more decreased activation in the bilateral frontal cortex, parietal lobule, anterior/posterior cingulate cortex and insula cortex under 2-back task. With the increase of task difficulty, the activation degree of the frontal and parietal cortex decreased. More importantly, we found that lower activation in frontal cortex and parietal lobule was associated with worse cognitive function in the HD-ESRD patients. These results demonstrate that the abnormal brain activity patterns of frontal cortex and parietal lobule may reflect the neural mediation of SWM impairment. Keywords Spatial working memory . End-stage renal disease . Hemodialysis . Brain activity patterns . Functional magnetic resonance imaging
* Lei Xie [email protected] * Shuhua Ma [email protected] 1
Department of Radiology, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
2
Shantou University Medical College, Shantou 515041, Guangdong, China
3
Guangdong Key Laboratory of Medical Molecular Imaging, Shantou 515041, China
4
Department of Ultrasound, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
5
Department of Pediatric Surgery, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, China
6
Mental Health Center, Shantou University Medical College, Shantou 515000, China
Introduction Cognitive impairment is common in patients with chronic kidney disease (Pi et al. 2016), especially those with endstage renal disease (ESRD) who are on hemodialysis (HD)
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