维持性血液透析伴认知功能障碍患者脑功能连接密度改变与全局神经血管解耦的分析OA

Objective:To investigate the changes in functional connectivity density(FCD)and global neurovascular coupling(NVC)in maintenance hemodialysis(MHD)patients with cognitive dysfunction,and to explore their clinical and pathophysiological mechanisms.Methods:Resting-state fMRI was performed in 29 MHD patients with cognitive dysfunction(MHD group)and 29 healthy controls(contorol group).Global FCD(gFCD),long-range FCD(lFCD),and short-range FCD(sFCD)were calculated.Global NVC was assessed by the correlation between cerebral blood flow(CBF)and FCD.Results:Compared with the control group,the MHD group showed the increased gFCD in the left hippocampus,parahippocampal gyrus,fusiform gyrus and globus pallidus,the increased lFCD in the right hippocampus,parahippocampal gyrus and thalamus,the increased sFCD in the left hippocampus,parahippocampal gyrus,fusiform gyrus,globus pallidus and inferior temporal gyrus,and the decreased sFCD in the left angular gyrus,supramarginal gyrus and postcentral gyrus.Compared with the control group,the global coupling coefficient of CBF-sFCD in the MHD group significantly decreased(P<0.05).In the MHD group,the lFCD in the right thalamus was negatively correlated with hemoglobin,and the lFCD in the right hippocampus was negatively correlated with the language function score,the sFCD in the left supramarginal gyrus was positively correlated with hemoglobin,and the sFCD in the left angular gyrus was negatively correlated with visuospatial function score,and the global coupling coefficients of CBF-gFCD and CBF-sFCD were positively correlated with language function score(both P<0.05).Conclusions:MHD patients with cognitive dysfunction exhibit widespread abnormalities in functional connectivity,and the decoupling of global NVC may play a critical role in cognitive dysfunction.