Diffusion tensor imaging for evaluation on cognitive and white matter damage in end-stage renal disease patients with secondary hyperparathyroidism
Objective To investigate cognitive and white matter microstructure damage in end-stage renal disease(ESRD)patients with secondary hyperparathyroidism(SHPT)with diffusion tensor imaging(DTI).Methods Data of 50 ESRD patients were retrospectively analyzed.The patients were divided into SHPT group or control group(each n=25)according to with hyperparathyroidism or not.The outcomes of mini-mental state examination(MMSE)were recorded,and the relevant clinical serological indicators were collected.Brain DTI data were reviewed,and anisotropy fraction(FA),mean diffusivity(MD),axial diffusivity(AD)and radial diffusivity(RD)obtained with DTI were compared between groups.The correlations of MMSE score,serological indicators and DTI parameters of brain regions being significantly different between control group and SHPT group were analyzed.Results Compared with control group,MMSE scores in SHPT group significantly reduced,while serum calcium level slightly increased(both P＜0.05).In SHPT group,FA and AD decreased in many brain regions,including cerebral hemisphere,cerebellum and brainstem,which in cerebral hemisphere mainly distributed in the right side,while RD increased in some brain regions.MMSE scores in SHPT group were negatively correlated with intact parathyroid hormone(iPTH)level(r=-0.800,P＜0.01).Serum calcium,phosphate and creatinine levels in SHPT group were negatively correlated with FA and AD(all r＜0,all P＜0.05),while serum phosphate level was positively correlated with RD in some brain regions(all r＞0,all P＜0.05).Conclusion Patients with ESRD and SHPT had cognitive dysfunction and extensive white matter microstructure damages,mainly present as axon damage,with right hemisphere lateralization and related to serum calcium,phosphate and creatinine levels.
万方数据
维普
