Altered Regional Brain Activity and Functional Connectivity Between Non-Diabetic and Diabetic Kidney Disease: A Resting-State fMRI Study.

INTRODUCTION

Patients with chronic kidney disease often exhibit impaired brain function; however, the differences between those with non-diabetic kidney disease (non-DKD) and diabetic kidney disease (DKD) remain poorly understood. This study aimed to investigate alterations in resting-state brain activity in patients with non-DKD and DKD.

METHODS

Thirty non-DKD patients, thirty DKD patients, and twenty-nine healthy controls underwent laboratory examinations and resting-state functional magnetic resonance imaging (rs-fMRI). The brain activity was analyzed using the amplitude of low-frequency fluctuations (ALFF) and seed-based functional connectivity (FC), and correlations between laboratory indicators and FC were examined.

RESULTS

Both non-DKD and DKD groups exhibited reduced ALFF in several brain regions, including the bilateral putamen, alongside elevated ALFF in the left middle occipital gyrus. Seed-based FC analysis revealed decreased connectivity between bilateral putamen and several regions, including decreased FC between the left putamen and left caudate. Compared with the non-DKD group, the DKD group demonstrated reduced ALFF in the left putamen and right precuneus, along with decreased FC between the right putamen and right thalamus. Several biomarkers, including urinary protein-to-creatinine ratio (UPCR), C-reactive protein (CRP), and hemoglobin (HGB), were associated with observed FC alterations.

CONCLUSION

Our findings indicate that DKD patients exhibit distinct patterns of brain activity compared to non-DKD patients, with the putamen potentially acting as a key neural target in the progression of CKD. These functional alterations correlate closely with systemic status, suggesting a significant role in the pathogenesis of neural impairment. Our results may enhance the understanding of neural functional alterations and the underlying mechanisms in non-DKD and DKD patients.