Cerebral blood flow changes in maintenance hemodialysis patients with restless legs syndrome and their clinical significance:a cross-sectional case-control study.

OBJECTIVE: Restless legs syndrome (RLS) stands as a prevalent neurological complication within maintenance hemodialysis (MHD) patients. However, the alterations in cerebral blood flow (CBF) among MHD-RLS patients remain uncharted. Through the utilization of the arterial spin labeling (ASL) technique, we evaluated the fluctuations in CBF within distinct brain regions and analyzed the risk factors for the development of RLS in MHD patients in the context of the clinic. METHODS: Thirty-one MHD patients with concomitant RLS (MHD-RLS group) and thirty-one non-RLS patients matched based on age, gender, as well as cognitive function (MHD-nRLS group) were included. Through image preprocessing and data analysis, the changes in CBF values in distinct brain regions were obtained, and the CBF values of brain regions with substantial differences between the two groups were correlated with the RLS scores. Furthermore, the differences in baseline data were compared, and through the utilization of multifactorial logistic regression, the independent risk factors for the development of RLS were examined. RESULTS: Compared with the MHD-nRLS group, the MHD-RLS group had increased CBF in the right superior temporal gyrus, reduced CBF in the right hippocampus, left middle frontal gyrus, inferior frontal gyrus of right triangle, middle frontal gyrus of left orbit, left precentral gyrus, and left precuneus. Only left precentral gyrus CBF were negatively correlated with RLS scores after correction for dialysis duration(r = -0.436, P = 0.016). Accordingly, multifactorial regression analysis by stepwise method yielded that the left precentral gyrus CBF values(OR: 0.968, 95%CI: 0.944-0.993, P = 0.012) remained an independent risk factor for RLS in MHD patients. In addition, the results showed that hemodialysis duration (OR: 1.055, 95%CI: 1.014-1.098, P = 0.008) and serum iron levels (OR: 0.685, 95%CI: 0.551-0.852, P = 0.001) were also risk factors for the development of RLS. CONCLUSION: Patients afflicted with MHD-RLS exhibit alterations in CBF across several brain regions. Notably, the left precentral gyrus might serve as a pivotal region influencing the onset of RLS among MHD patients. Furthermore, extended hemodialysis duration and a relative insufficiency in serum iron levels independently contribute as risk factors for RLS development within the MHD patient population.

Using quantitative imaging to determine the correlation between hypothalamic inflammation and anxiety and depression in young patients with obesity.

BACKGROUND: To investigate the incidence of anxiety and depressive disorders in young adults with obesity and the correlation between the severity of these disorders and hypothalamic inflammation. METHODS: The severity of anxiety and depressive disorders was assessed using the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), respectively. Hypothalamic inflammation was evaluated by measuring the hypothalamus/amygdala (H/A) signal intensity (SI) ratio in T2-weighted phase quantitative magnetic resonance imaging (MRI). RESULTS: The incidence of depressive disorders in young (18-45 years) patients with obesity (n=66) was higher than that in the control group (n=44); anxiety disorder incidence did not differ significantly between groups. The bilateral H/A SI ratio in the obesity group was significantly higher than that in the control group. In the obesity group, there was no significant correlation between bilateral H/A SI ratio and body mass index (BMI) (right: r=-0.145, P=0.721; left: r=0.102, P=0.415) or SAS scores (right: r=-0.118, P=0.444; left: r=-0.295, P=0.052); SDS scores were significantly correlated with left H/A SI ratio (r=-0.353, P=0.019), but not right H/A SI ratio (r=-0.031, P=0.843). CONCLUSIONS: Patients with obesity had a higher incidence of depressive disorders. Left hypothalamus inflammation may be one of the links between obesity and depressive disorders.