基于多模态磁共振成像研究贫血对慢性肾病患者认知功能损害的神经机制

.In chronic kidney disease (CKD) patients，the prevalence of cognitive impairment has been estimated at 30% -60%. The neural mechanisms is complex and unclear, researchers report that anemia, dialysis, uremic toxins and other many factors associated with it. Anemia is one of the most common complication of CKD. Our previous study found that anemia can increased the whole brain cerebral blood flow in patients with CKD. In this study, we use a multi-modal magnetic resonance imaging to research the anemia on brain perfusion, function, structural changes with cognitive impairment. Comparison the results of regional cerebral blood flow, regional homogeneity, functional connectivity density, voxel-based morphological analysis, psychological tests and blood biochemistry tests findings. To find the specific brain areas and function networks in CKD patients with anemia, and then find out sensitive and specific functional and structural neuroimaging biomarkers, providing objective neuroimaging clues for diagnosis and intervention of cognitive impairment in CKD patients.

慢性肾病（CKD）患者认知损害发生率高达30%-60%。其神经机制复杂，研究发现贫血、透析、尿毒症毒素等多种因素与其有关，但具体神经机制尚不明确。贫血是CKD最常见并发症之一，课题组前期研究发现贫血能导致CKD患者全脑灌注增高。本研究拟通过多模态磁共振成像来研究不同类别贫血对脑灌注、功能、结构改变与认知损害的关系。比较各组局部脑灌注、局部一致性、功能连接密度、基于体素形态学分析等神经影像学结果，与神经心理学量表、血液学检查结果进行相关分析，寻找贫血引起CKD患者认知损害的特异性脑区及功能网络，揭示贫血这一因素引起认知损害的功能、结构基础，进而筛选出敏感、特异的影像学指标，为CKD患者认知损害诊断及干预提供客观的影像学依据。

慢性肾病（CKD）患者认知损害发生率高达30%-60%。其神经机制复杂，研究发现贫血、透析、尿毒症毒素、肠道菌群等多种因素与其有关，但具体神经机制尚不明确。本研究拟通过多模态磁共振成像来研究贫血、肠道菌群对脑灌注、功能、结构改变与认知损害的关系。研究发现CKD患者脑结构功能变化、认知情绪改变与肠道菌群的失调间存在着一定的相关性。炎性细胞因子在CKD的背景下介导了肠道菌群对大脑的影响，这表明了益生菌在治疗CKD诱发的认知障碍中的潜在作用。本研究首先揭示了慢性肾病患者肠道菌群改变，全身炎症，DMN分离和认知功能障碍之间的内在联系。