Disturbed neurovascular coupling in hemodialysis patients

Mei Jin; Liyan Wang; Hao Wang; Xue Han; Zongli Diao; Wang Guo; Zhenghan Yang; Heyu Ding; Zheng Wang; Peng Zhang; Pengfei Zhao; Han Lv; Wenhu Liu; Zhenchang Wang

doi:10.7717/peerj.8989

Disturbed neurovascular coupling in hemodialysis patients

PeerJ. 2020 Apr 15:8:e8989. doi: 10.7717/peerj.8989. eCollection 2020.

Authors

Mei Jin¹, Liyan Wang², Hao Wang¹, Xue Han², Zongli Diao², Wang Guo², Zhenghan Yang¹, Heyu Ding¹, Zheng Wang¹, Peng Zhang¹, Pengfei Zhao¹, Han Lv¹, Wenhu Liu², Zhenchang Wang¹

Affiliations

¹ Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
² Department of Nephrology, Faculty of Kidney Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.

Abstract

Background: Altered cerebral blood flow (CBF) and amplitude of low-frequency fluctuation (ALFF) have been reported in hemodialysis patients. However, neurovascular coupling impairments, which provide a novel insight into the human brain, have not been reported in hemodialysis patients.

Methods: We combined arterial spin labeling (ASL) and blood oxygen level dependent (BOLD) techniques to investigate neurovascular coupling alterations and its relationships with demographic and clinical data in 46 hemodialysis patients and 47 healthy controls. To explore regional neuronal activity, ALFF was obtained from resting-state functional MRI. To measure cerebral vascular response, CBF was calculated from ASL. The across-voxel CBF-ALFF correlations for global neurovascular coupling and CBF/ALFF ratio for regional neurovascular coupling were compared between hemodialysis patients and healthy controls. Two-sample t-tests were used to compare the intergroup differences in CBF and ALFF. Multiple comparisons were corrected using a voxel-wise false discovery rate (FDR) method (P < 0.05).

Results: All hemodialysis patients and healthy controls showed significant across-voxel correlations between CBF and ALFF. Hemodialysis patients showed a significantly reduced global CBF-ALFF coupling (P = 0.0011) compared to healthy controls at the voxel-level. Of note, decreased CBF/ALFF ratio was exclusively located in the bilateral amygdala involved in emotional regulation and cognitive processing in hemodialysis patients. In hemodialysis patients, the decreased CBF (right olfactory cortex, anterior cingulate gyrus and bilateral insula) and ALFF (bilateral precuneus and superior frontal gyrus) were mainly located in the default mode network and salience network-related regions as well as increased CBF in the bilateral thalamus.

Conclusions: These novel findings reveal that disrupted neurovascular coupling may be a potential neural mechanism in hemodialysis patients.

Keywords: Across-voxel CBF-ALFF correlations; Amplitude of low-frequency fluctuation (ALFF); Amygdala; Arterial spin labeling (ASL); CBF/ALFF ratio; Cerebral blood flow (CBF); End-stage renal disease; Hemodialysis; Neurovascular coupling; Neurovascular unit.

Grants and funding

This study was supported by the National Natural Science Foundation of China (61527807, 81701644 and 61801311), the Beijing Municipal Administration of Hospitals Mission Plan (SML20150101), the Beijing Scholars Program ((2015) 160), Beijing Natural Science Foundation (7172064, 7162048 and 7182044), the Beijing Municipal, Administration of Hospitals (PX2018001 and QML20180103), and the Beijing Friendship Hospital, Capital Medical University (YYZZ2017B01). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.