Altered brain entropy and functional connectivity patterns in peritoneal dialysis patients

ObjectiveTo explore abnormal changes in brain entropy (BEN) and resting-state functional connectivity (RSFC) in peritoneal dialysis (PD) patients and their associations with cognitive impairment (CI).MethodsFifty-three PD patients and 49 age-, gender-, and education-matched healthy controls (HCs) were enrolled. Resting-state functional magnetic resonance imaging (rs-fMRI) was performed to calculate BEN and RSFC. Neuropsychological assessments and clinical indicator collection were conducted. PD patients were divided into mild cognitive impairment (MCI) and non-cognitive impairment (NCI) groups using Montreal Cognitive Assessment (MoCA) scores. Correlation analyses were performed between BEN/RSFC values and neuropsychological/clinical indicators.ResultsPD patients exhibited significantly poorer performance in multiple cognitive scales than HCs (all p < 0.001). Compared with HCs, PD patients had decreased BEN in the right middle occipital gyrus and left caudate nucleus, and increased BEN in the left middle temporal gyrus and right fusiform gyrus. Reduced RSFC was found between the right middle occipital gyrus and the right fusiform gyrus, right middle frontal gyrus, and right precuneus in PD patients. BEN and RSFC values were correlated with emotional scale scores, cognitive scale subscores, and clinical indicators (e.g., glycosylated hemoglobin, transferrin saturation).ConclusionPatients with end-stage kidney disease undergoing peritoneal dialysis present abnormal brain entropy and functional connectivity patterns. These alterations are associated with systemic metabolic disorders, long-term dialysis treatment, and cognitive/emotional impairment.