老年终末期肾病患者脑影像学皮质结构改变与抑郁、消极应对方式之间的关系OA

Objective:To explore the relationship between cortical structural changes in brain imaging and depression and negative coping styles in elderly patients with end-stage renal disease(ESRD).Methods:A total of 35 elderly ESRD patients were included in the ESRD group,whereas another 41 older healthy volunteers were included in the control group.All participants underwent 3D-T1WI scans and were evaluated to complete MMSE,PHQ-9 and simple coping styles questionnaire.The analysis compared cortical thickness differences between the two groups using surface-based morphometry measurements with FreeSurfer software.Using the cortical thickness in the different brain regions as the mediating variable and the coping style score as the moderating variable,a moderated mediation analysis was conducted within the bruceR package of the R language platform.Results:Compared with the control group,the cortical thickness in the left precuneus,bilateral insula and bilateral superior temporal gyri decreased in the ESRD group(all P<0.05).The overall cortical thickness and that in the left precuneus,left insula,left superior temporal gyrus and right insula were negatively correlated with PHQ-9 score(r=-0.435,PFDR<0.001;r=-0.503,PFDR<0.001;r=-0.423,PFDR<0.001;r=-0.391,PFDR<0.001;r=-0.240,PFDR=0.048).Mediation analysis showed that the cortical thickness in the left superior temporal gyrus completely mediated between ESRD and depression(β=-1.30,P>0.05),and an intermediate-high level of negative coping style played a moderating role in this relationship.Conclusions:Cortical structural changes in multiple brain regions of elderly ESRD patients are associated with depression.Negative coping style plays a regulatory role in depression mediated by structural abnormalities in the left superior temporal gyrus.This result may provide potential neuro-psychological markers for the treatment intervention of elderly ESRD patients.