Functional-structural relationship in large-scale brain networks of patients with end stage renal disease after kidney transplantation: A longitudinal study

It is unclear how the brain network changed after kidney transplantation (KT). We explored the patterns of large-scale complex network after KT in end-stage renal disease (ESRD) patients with resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI). Twenty-one ESRD patients (14 men; mean age, 31.5 +/- 9.9 years) scheduled for KT and 17 age- and gender-matched healthy controls (HC) (8 men; mean age, 28.9 +/- 7.2 years) were enrolled in this study. Each participant underwent rs-fMRI and DTI scans in three time points (pre-KT, 1 and 6 months after KT [for ESRD]). Graph theory analysis was used to characterize the topological properties by using functional and structural network connectivities intergroup correlation analysis was performed between functional/structural MR indexes and clinical markers. Compared with HC, pre-KT ESRD patients showed an altered topological organization in both functional and structural networks. Compared with pre-KT, increased node degree and node efficiency were observed for both functional and structural networks at 1 month after KT (all p < .05), which were further increased at 6 months after KT (p < .05). Both functional and structural networks did not recover completely at 6 months after KT (all p < .05). The patients showed an increased functional-structural connectivity coupling at 1 month after KT compared with HC (p = .041). A trend of progressive recovery of functional and structural connectivity networks was observed in ERSD patients after KT, which did not recover to the normal levels even in 6 months after KT. The study results underlie cognitive function recovery in ESRD patients following KT in the neuropathophysiological perspective.