1
|
Jeong H, Yeo H, Lee KH, Kim N, Shin J, Seo MC, Jeon S, Lee YJ, Kim SJ. Brain structural correlates of subjective sleepiness and insomnia symptoms in shift workers. Front Neurosci 2024; 18:1330695. [PMID: 38440391 PMCID: PMC10909910 DOI: 10.3389/fnins.2024.1330695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Background Studies on the brain structures of shift workers are limited; thus, this cross-sectional study aimed to compare the brain structures and the brain structural correlates of subjective sleepiness and insomnia symptoms between shift workers and non-shift workers. Methods Shift workers (n = 63) and non-shift workers (n = 58) completed questionnaires assessing subjective sleepiness and insomnia symptoms. Cortical thickness, cortical surface area, and subcortical volumes were measured by magnetic resonance imaging. The brain morphometric measures were compared between the groups, and interaction analyses using the brain morphometric measures as the dependent variable were performed to test the interactions between the study group and measures of sleep disturbance (i.e., subjective sleepiness and insomnia symptoms). Results No differences in cortical thickness, cortical surface area, or subcortical volumes were detected between shift workers and non-shift workers. A single cluster in the left motor cortex showed a significant interaction between the study group and subjective sleepiness in the cortical surface area. The correlation between the left motor cortex surface area and the subjective sleepiness level was negative in shift workers and positive in non-shift workers. Significant interaction between the study group and insomnia symptoms was present for the left/right putamen volumes. The correlation between the left/right putamen volumes and insomnia symptom levels was positive in shift workers and negative in non-shift workers. Conclusion Left motor cortex surface area and bilateral putamen volumes were unique structural correlates of subjective sleepiness and insomnia symptoms in shift workers, respectively.
Collapse
Affiliation(s)
- Hyunwoo Jeong
- Department of Education and Training, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Hyewon Yeo
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Nambeom Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Jiyoon Shin
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Cheol Seo
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| |
Collapse
|
2
|
Song L, Liu X, Yang W, Li M, Xu B, Chen Q, Yang Z, Liu W, Wang H, Wang Z. Association of aberrant structural-functional network coupling with cognitive decline in patients with non-dialysis-dependent stage 5 chronic kidney disease. Quant Imaging Med Surg 2023; 13:8611-8624. [PMID: 38106236 PMCID: PMC10721997 DOI: 10.21037/qims-23-295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 10/07/2023] [Indexed: 12/19/2023]
Abstract
Background Cognitive decline exists in the chronic kidney disease (CKD) population and is particularly severe in patients with stage 5 CKD, but the mechanisms underlying this relationship are unclear. Structural-functional coupling, an integrated measure that combines functional and structural networks, offers the possibility of exploring changes in network relationships in patients with stage 5 CKD. This study aimed to investigate the brain network topology and structural-functional coupling characteristics in patients with non-dialysis-dependent stage 5 CKD (CKD 5ND) and the correlation between network changes and cognitive scores. Methods We prospectively performed diffusion tensor and resting-state functional magnetic resonance (rs-fMRI) imaging on 40 patients with CKD 5ND disease and 47 healthy controls (HCs). Graph theory analysis of functional and structural connectivity (SC) was performed. Small-world properties and network efficiency properties were calculated, including characteristic path length (Lp), clustering coefficient (Cp), normalized clustering coefficient (Gamma), normalized characteristic path length (Lambda), small-worldness (Sigma), global efficiency (Eglob), and local efficiency (Eloc). The SC-functional connectivity (FC) coupling characteristics and the association between Montreal Cognitive Assessment (MoCA) scores and graph-theoretical features were analyzed. Results For SC, the Sigma (P=0.009), Cp (P=0.01), Eglob (P<0.001), and Eloc (P=0.01) were significantly lower in patients with CKD 5ND than in HCs, while Lp (P<0.001) and Lambda (P<0.001) were significantly higher in the patients than in the HCs. For FC, the Sigma (P=0.008), Gamma (P=0.009), Eglob (P=0.04), and Eloc (P<0.0001) were lower in patients with CKD 5ND than in HCs; however, the Lp (P=0.02) was higher in the patients than in the HCs. SC-SC coupling (P<0.001) was greater in patients with CKD 5ND than in HCs. The structural (Cp, Eloc, Eglob) and functional network parameters (Sigma, Gamma, Eglob) of the patients with CKD 5ND were positively correlated with MoCA scores; however, the Lp of both structural and functional networks was negatively correlated with MoCA scores. Conclusions All patients with CKD 5ND included in the study exhibited changes in their structural and functional brain network topology closely related to mild cognitive impairment. SC-SC coupling was elevated in the patients compared with that in the controls. This may provide vital information for understanding and revealing the underlying mechanisms of cognitive impairment in patients with CKD 5ND.
Collapse
Affiliation(s)
- Lijun Song
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Xu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wenbo Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Mingan Li
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Boyan Xu
- MR Research, GE Healthcare, Beijing, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Wenhu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Hao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
3
|
Yuan H, Luo Z, Gu W, Ma S, Li G, Ding D, Ma X, Li P, Yang J, Xu X, Mu J, Zhang M. Abnormal grey matter structural changes in patients with end-stage kidney disease and mild cognitive impairment: correlations with clinical features. Metab Brain Dis 2023; 38:2817-2829. [PMID: 37776380 PMCID: PMC10663233 DOI: 10.1007/s11011-023-01293-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/12/2023] [Indexed: 10/02/2023]
Abstract
End-stage kidney disease and mild cognitive impairment (ESKD-MCI) affect the quality of life and long-term treatment outcomes of patients affected by these diseases. Clarifying the morphological changes from brain injuries in ESKD-MCI and their relationship with clinical features is helpful for the early identification and intervention of MCI before it progresses to irreversible dementia. This study gathered data from 23 patients with ESKD-MCI, 24 patients with ESKD and non-cognitive impairment (NCI), and 27 health controls (HCs). Structural magnetic resonance studies, cognitive assessments, and general clinical data were collected from all participants. Voxel-based morphometry analysis was performed to compare grey matter (GM) volume differences between the groups. The patients' GM maps and clinical features were subjected to univariate regression to check for possible correlations. Patients with ESKD-MCI displayed significantly more impairments in multiple cognitive domains, including global cognition, visuospatial and executive function, and memory, compared to patients with ESKD-NCI. Using a more liberal threshold (P < 0.001, uncorrected), we found that compared to patients with ESKD-NCI, patients with ESKD-MCI exhibited clusters of regions with lower GM volumes, including the right hippocampus (HIP), parahippocampal gyrus (PHG), Rolandic operculum, and supramarginal gyrus. The volumes of the right HIP and PHG were negatively correlated with serum calcium levels. ESKD-MCI was associated with a subtle volume reduction of GM in several brain areas known to be involved in memory, language, and auditory information processing. We speculate that these slight morphometric impairments may be associated with disturbed calcium metabolism.
Collapse
Affiliation(s)
- Huijie Yuan
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Zhaoyao Luo
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Wen Gu
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Shaohui Ma
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Guangyu Li
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Dun Ding
- Department of Medical Imaging, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xueying Ma
- Department of Medical Imaging, the Affiliated Hospital of Inner Mongolia Medical University, Hohhot, Inner Mongolia, China
| | - Peng Li
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Jing Yang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Xiaoling Xu
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China
| | - Junya Mu
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, 710061, China.
| |
Collapse
|
4
|
Song L, Liu X, Yang W, Chen Q, Lv H, Yang Z, Liu W, Wang H, Wang Z. Altered Resting-State Functional Networks in Nondialysis Patients with Stage 5 Chronic Kidney Disease: A Graph-Theoretical Analysis. Brain Sci 2023; 13:brainsci13040628. [PMID: 37190593 DOI: 10.3390/brainsci13040628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/21/2023] [Accepted: 04/04/2023] [Indexed: 05/17/2023] Open
Abstract
This study aimed to investigate the topological characteristics of the resting-state functional network and the underlying pathological mechanism in nondialysis patients with stage 5 chronic kidney disease (CKD5 ND). Eighty-five subjects (21 patients with CKD5 ND, 32 patients with CKD on maintenance hemodialysis (HD), and 32 healthy controls (HCs)) underwent laboratory examinations, neuropsychological tests, and brain magnetic resonance imaging. The topological characteristics of networks were compared with a graph-theoretical approach, and correlations between neuropsychological scores and network properties were analyzed. All participants exhibited networks with small-world attributes, and global topological attributes were impaired in both groups of patients with CKD 5 (ND and HD) compared with HCs (p < 0.05); these impairments were more severe in the CKD5 ND group than in the HD group (p < 0.05). Compared with the HC group, the degree centrality of the CKD5 ND group decreased mainly in the basal ganglia and increased in the bilateral orbitofrontal gyrus, bilateral precuneus, and right cuneus. Correlation analysis showed that the degree of small-worldness, normalized clustering coefficients, and Montreal Cognitive Assessment (MoCA) scores were positively correlated and that characteristic path length was negatively correlated with these variables in patients with CKD5 ND. The nodal efficiency of the bilateral putamen (r = 0.53, p < 0.001 and r = 0.47, p < 0.001), left thalamus (r = 0.37, p < 0.001), and right caudate nucleus (r = 0.28, p = 0.01) was positively correlated with MoCA scores. In conclusion, all CKD5 ND patients exhibited changes in functional network topological properties and were closely associated with mild cognitive impairment. More interestingly, the topological property changes in CKD5 ND patients were dominated by basal ganglia areas, which may be more helpful to understand and possibly reveal the underlying pathological mechanisms of cognitive impairment in CKD5 ND.
Collapse
Affiliation(s)
- Lijun Song
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Xu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Wenbo Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Wenhu Liu
- Department of Nephrology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Hao Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong An Road, Beijing 100050, China
| |
Collapse
|
5
|
Zheng J, Jiao Z, Dai J, Liu T, Shi H. Abnormal cerebral micro-structures in end-stage renal disease patients related to mild cognitive impairment. Eur J Radiol 2022; 157:110597. [DOI: 10.1016/j.ejrad.2022.110597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 10/20/2022] [Accepted: 11/06/2022] [Indexed: 11/13/2022]
|
6
|
Yuan H, Li H, Mu J, Gu W, Zhu X, Gao L, Zhang Y, Ma S. Reduced cortical complexity in patients with end-stage kidney disease prior to dialysis initiation. Front Neurosci 2022; 16:971010. [PMID: 36389216 PMCID: PMC9659747 DOI: 10.3389/fnins.2022.971010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/12/2022] [Indexed: 11/24/2022] Open
Abstract
End-stage kidney disease (ESKD) is associated with cognitive impairment (CI) and affects different aspects of cortical morphometry, but where these changes converge remains unclear. Fractal dimension (FD) is used to represent cortical complexity (CC), which describes the structural complexity of the cerebral cortex by integrating different cortical morphological measures. This study aimed to investigate changes in CC in patients with ESKD prior to initiation of dialysis and to evaluate the relationship between changes in CC, cognitive performance, and uremic toxins. Forty-nine patients with ESKD naive to dialysis and 31 healthy controls (HCs) were assessed using structural magnetic resonance imaging (MRI) and cognitive tests, including evaluations of global cognitive function, memory, and executive function. Clinical laboratory blood tests were performed on all patients with ESKD, including measurement of nine uremic toxin-related indices. CC was measured using MRI data to determine regional FD values. We estimated the association between cognitive performance, uremic toxin levels, and CC changes. Compared to HCs, patients with ESKD showed significantly lower CC in the left precuneus (p = 0.006), left middle temporal cortex (p = 0.010), and left isthmus cingulate cortex (p = 0.018). Furthermore, lower CC in the left precuneus was associated with impaired long-term delayed memory (Pearson r = 0.394, p = 0.042) in patients with ESKD. Our study suggests that regional decreases in CC are an additional characteristic of patients with ESKD naive to dialysis, related to impaired long-term memory performance. These findings may help further understand the underlying neurobiological mechanisms between brain structural changes and CI in patients with ESKD.
Collapse
Affiliation(s)
- Huijie Yuan
- Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Haining Li
- Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Junya Mu
- Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wen Gu
- Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xinyi Zhu
- Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yuchen Zhang
- Department of Nuclear Medicine, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- Yuchen Zhang,
| | - Shaohui Ma
- Department of Medical Imaging, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Shaohui Ma,
| |
Collapse
|