Reduced functional connectivity induced by longitudinal changes of structure and perfusion in hemodialysis patients with cognitive impairment

Motivation: Hemodialysis (HD) leads to cognitive impairment; however, the pathophysiology of maintenance HD remains unclear. Goal(s): This study aimed to investigate the longitudinal alterations in gray matter volume (GMV), cerebral blood flow (CBF) and functional connectivity (FC) in patients on follow-up HD compared with baseline HD. Approach: All participants underwent high-resolution T1-weighted imaging, arterial spin labeling, and functional MR imaging to measure GMV, CBF, and FC. Results: The right and left medial superior frontal gyrus (SFGmed.L) exhibited significantly lower GMV and CBF in patients on follow-up HD compared with baseline HD and lower FC between the SFGmed.L and left middle temporal gyrus. Impact: Our findings provide unique insights into the pathological mechanisms of patients on maintenance HD with cognitive impairment.