Brain volume changes in patients with maintaining hemodialysis and the correlation with sleep quality, anxiety and depression / 中国医学影像技术

ABSTRACT

Objective To investigate the changes of cerebral volume in end stage renal disease (ESRD) patients with maintaining hemodialysis using voxel based morphometry (VBM),and to observe the correlation of these changes with sleep quality,anxiety and depression.Methods Twenty ESRD patients received maintaining hemodialysis (patient group) and twenty-one normal volunteers (normal control group) underwent MRI and neuropsychological scale evaluations,including the Montreal Cognitive Assessment Scale (MoCA),Pittsburgh Sleep Quality Index Scale (PSQI),Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS).The changes of cerebral volume between the two groups were compared,and the correlation between the changed area of cerebral volume in patient group and the score of neuropsychological scale was analyzed.Results Compared with normal control group,significantly decreased volume in the gray matter of the left middle temporal gyrus,right middle frontal gyrus and left medial frontal gyrus were observed in patient group (all P＜0.001,AlphaSim multiple corrections).The differences of MoCA,PSQI,SAS and SDS between the two groups were statistically significant (all P＜0.05).In patient group,the decreased gray matter volume of the left middle temporal gyrus negativity correlated with PSQI,SDS and SAS (r=-0.588,-0.456,-0.489;P =0.006,0.043,0.029),of the right middle frontal gyrus negativity correlated with SDS and SAS (r=-0.495,-0.466;P=0.026,0.038),of the left medial frontal gyrus positively correlated with MoCA (r=0.462,P=0.040),and negatively correlated with PSQI (r=-0.588,P=0.006).Conclusion Multiple grey matter atrophy and complicated neurocognitive dysfunction were noticed in ESRD patients with maintaining hemodialysis,and the associated poorer sleep quality,anxiety or depression severity might closely related to the decreased volume of corresponding brain gray matter.