Cortical and subcortical gray matter bases of sleep disturbance in patients with end-stage renal disease undergoing hemodialysis

Motivation: Hemodialysis (HD) patients can cause alterations in cortical and subcortical structures, and often experience cognitive and sleep disorders (SD). However, the mechanism of SD in HD patients is not fully understood. Goal(s): To assess cortical and subcortical gray matter changes in HD patients with SD and explore associations with cognitive function. Approach: Cortical surface-based analysis and vertex-wise shape analysis approaches were used to investigate cortical and subcortical gray matter abnormalities. Results: Hemodialysis patients with sleep disorder exhibited widespread cortical thinning and significant surface reduction on the right hippocampus. Impact: Cortical and subcortical gray matter abnormalities are associated with sleep quality in HD patients, with a more widespread pattern observed in patients with SD. Our findings highlight the importance of distinguishing HD patient subgroups based on sleep quality.