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. 2024 Dec 19;24(1):486.
doi: 10.1186/s12883-024-03985-6.

Alterations in spontaneous brain activity of maintenance hemodialysis patients with restless legs syndrome: a cross-sectional case-control study

Di Wang #  1   2 , Wenqing Li #  3 , Yushang Tang  1   4 , Wanfen Zhang  1   4 , Tongqiang Liu  5 , Haifeng Shi  6
Affiliations

Alterations in spontaneous brain activity of maintenance hemodialysis patients with restless legs syndrome: a cross-sectional case-control study

Di Wang et al. BMC Neurol. .

Abstract

Objective: Through resting state functional magnetic resonance imaging (rs-fMRI) we evaluate the spontaneous brain activity changes of maintenance hemodialysis (MHD) patients with restless legs syndrome (RSL) and analyzed the imaging features and related mechanisms of RLS in patients with MHD.

Method: We select 27 MHD patients with RLS and 27 patients without RSL matched by age, gender, cognitive function. Both groups underwent neuropsychological tests and MRI scans. MRI data analysis was performed to obtain and compare the amplitude of low-frequency fluctuation (ALFF), fractional amplitude of low-frequency fluctuations (fALFF), and regional homogeneity (ReHo) values, which were mALFF, mfALFF, and mReHo. Clinical data were collected and compared. Differentiated indicators and RLS scores conduct Pearson correlation analysis.

Result: Compared with the MHD-nRLS group, the MHD-RLS group showed significantly lower mALFF values in the left precentral, right precentral gyrus, and right postcentral gyrus, lower mfALFF values in the left precentral gyrus, right precentral gyrus, left calcarine fissure, left lingual gyrus, left postcentral gyrus, and right postcentral gyrus, and lower mReHo values in the left precentral gyrus, right precentral gyrus, left calcarine fissure, left lingual gyrus, left postcentral gyrus, and right postcentral gyrus, and right postcentral gyrus (P < 0.05). The MHD-RLS group exhibited lower hemoglobin levels (P = 0.001), higher total iron-binding capacity levels (P = 0.011), and higher folic acid levels (P = 0.022). The above indicators were correlated with RLS scores using Pearson correlation analysis, and it was found that the mfALFF value of the right precentral gyrus and the right postcentral gyrus, and the mReHo values of the right precentral gyrus and right postcentral gyrus were negatively correlated with the RLS score (r = -0.567, P = 0.002;r = -0.705, P < 0.001;r = -0.414, P = 0.032; r = -0.410, P = 0.034), and the hemoglobin concentration was negatively correlated with the RLS scores (r = -0.394, P = 0.042).

Conclusion: Patients with MHD-RLS exhibit abnormal spontaneous brain activity in the right precentral gyrus and right postcentral gyrus within the sensorimotor network, along with lower hemoglobin levels, which may be associated with the pathogenesis and severity of MHD-RLS.

Keywords: Hemodialysis; Resting-state functional magnetic resonance imaging; Restless legs syndrome.

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Conflict of interest statement

Declarations. Ethical approval and consent to participate: This study was approved by the Ethics Committee of the Third Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China ([2022]KY005-01). The study was conducted in accordance with the Declaration of Helsinki and its later amendments. Informed consent was obtained from all participants and their legal guardians in the study. Consent for publication: Not Applicable. All of our identifying images and other personal or clinical details of participants are presented that compromise anonymity. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Comparison of mALFF differences between MHD-RLS group and MHD-nRLS group. The coloured areas indicate significantly higher mALFF values in the MHD-nRLS group compared to the MHD-RLS group
Fig. 2
Fig. 2
Comparison of mfALFF differences between MHD-RLS group and MHD-nRLS: group The coloured areas indicate significantly higher mfALFF values in the MHD-nRLS group compared to the MHD-RLS group
Fig. 3
Fig. 3
Comparison of mReHo differences between MHD-RLS group and MHD-nRLS group: The coloured areas indicate significantly higher mReHo values in the MHD-nRLS group compared to the MHD-RLS group
Fig. 4
Fig. 4
Correlation analysis. A: The mfALFF value of the right precentral gyrus in MHD-RLS patients is negatively correlated with the RLS scores (r =- 0.567, P = 0.002); B: The mALFF value of the right postcentral gyrus in MHD-RLS patients is negatively correlated with the RLS scores (r = -0.705, P < 0.001); C: The mReho value of the right precentral gyrus in MHD-RLS patients is negatively correlated with the RLS scores (r = -0.414, P = 0.032); D: The mReho value of the right postcentral gyrus in MHD-RLS patients is negatively correlated with the RLS scores (r = -0.410, P = 0.034); E: The hemoglobin concentration in MHD-RLS patients is negatively correlated with the RLS scores (r = -0.394, P = 0.042)
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