Reduced regional cerebral venous oxygen saturation is a risk factor for the cognitive impairment in hemodialysis patients: a quantitative susceptibility mapping study

• Published in: Brain imaging and behavior Vol. 14; no. 5; pp. 1339 - 1349
• Main Authors: Chai, Chao, Wang, Huiying, Chu, Zhiqiang, Li, Jinping, Qian, Tianyi, Mark Haacke, E., Xia, Shuang, Shen, Wen
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.10.2020; Springer Nature B.V
• Subjects: Analysis of covariance; Biomedical and Life Sciences; Biomedicine; Blood pressure; Cognition; Cognitive ability; Cognitive Dysfunction - diagnostic imaging; Cognitive Dysfunction - etiology; Correlation analysis; Cortex; Covariance; Dialysis; Glucose; Hematocrit; Hemodialysis; Humans; Impairment; Iron; Magnetic Resonance Imaging; Mapping; Measuring techniques; Neuropsychology; Neuroradiology; Neurosciences; Original Research; Oxygen; Oxygen content; Oxygen saturation; Patients; Prospective Studies; Psychiatry; Psychology; Regional analysis; Regression analysis; Renal Dialysis; Risk analysis; Risk Factors; Veins; Veins & arteries; Quantitative susceptibility mapping; Neurocognitive impairment; Regional cerebral venous oxygen saturation; Susceptibility weighted imaging; Hemodialysis
• ISSN: 1931-7557; 1931-7565; 1931-7565
• DOI: 10.1007/s11682-018-9999-5

The purpose of this study was to noninvasively evaluate the changes of regional cerebral venous oxygen saturation (rSvO 2 ) in hemodialysis patients using quantitative susceptibility mapping (QSM) and investigate the relationship with clinical risk factors and neuropsychological testing. Fifty four (54) hemodialysis patients and 54 age, gender and education matched healthy controls (HCs) were recruited in this prospective study. QSM data were reconstructed from the original phase data of susceptibility weighted imaging to measure the susceptibility of cerebral regional major veins in all subjects and calculate their rSvO 2 . The differences in rSvO 2 between hemodialysis patients and HCs were investigated using analysis of covariance adjusting for age and gender as covariates. Stepwise multiple regression and correlation analysis were performed between the cerebral rSvO 2 and clinical factors including neuropsychological testing. The SvO 2 of the bilateral cortical, thalamostriate, septal, cerebral internal and basal veins in hemodialysis patients was significantly lower than that in HCs ( p  < 0.001, Bonferroni corrected). The cerebral rSvO 2 in all these veins was reduced by 1.67% to 2.30%. The hematocrit, iron, glucose, pre-and post-dialysis diastolic blood pressure (DBP) were independent predictive factors for the cerebral rSvO 2 (all P  < 0.05). The Mini-Mental State Examination and Montreal Cognitive Assessment (MoCA) scores were both lower in patients than those in HCs (both P  < 0.05). The SvO 2 of the left cerebral internal vein correlated with MoCA scores ( r  = 0.492; P  = 0.02, FDR corrected). In conclusion, our study indicated that the cerebral rSvO 2 was reduced in hemodialysis patients, which was the risk factor for neurocognitive impairment. The hematocrit, iron, glucose, pre-and post-dialysis DBP were independent risk factors for the cerebral rSvO 2 .