Abnormal Interhemispheric Functional Connectivity in Neurologically Asymptomatic Patients With End-Stage Renal Disease

Objective: This study aims to investigate the alterations in interhemispheric functional connectivity in neurologically asymptomatic patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis (HD) using resting-state functional magnetic resonance imaging (rs-fMRI) with voxel-mirrored homotopic connectivity (VMHC) algorithm. Methods: The rs-fMRI data were acquired from 40 neurologically asymptomatic patients with ESRD and 34 matched healthy control (HC) subjects. All subjects underwent neuropsychological tests, and patients with ESRD underwent laboratory tests. Intergroup VMHC differences in the voxel manner were analyzed. Correlation analysis was performed to evaluate the relationships between VMHC values and clinical variables in patients with ESRD. We further performed a receptive operation characteristic (ROC) analysis to confirm the sensitivity and specificity of our results. Results: Compared with HCs, patients with ESRD exhibited significantly decreased VMHC values in the inferior parietal lobule (IPL), superior temporal gyrus (STG), insula, precentral gyrus (PreCG), middle occipital gyrus (MOG), and calcarine/lingual/cuneus. Patients with ESRD did not exhibit increased VMHC values in any brain regions compared with HCs. Furthermore, the VMHC value of MOG was positively correlated with hemoglobin levels in patients with ESRD. Conclusions: The results revealed that the impairment of interhemispheric coordination in patients with ESRD, which provided preliminary evidence of VMHC as a potential biomarker of patients with ESRD.