Longitudinally altered default mode network and insula multimodal brain pattern in end-stage renal disease during sustained hemodialysis treatment.
iScience June 19, 2026 Chuang Liang, Wenhao Jiang, Jiayu Chen et al.
A specific pattern of altered connectivity between the default mode network and the insula, detected via unsupervised fusion of functional and structural MRI, was found in 39 people with end-stage renal disease receiving hemodialysis over one year. This pattern was linked to cognitive performance, and its associated genes were enriched in DNA damage repair, energy metabolism, and cellular activation. The baseline pattern predicted future cognition in this group, and similar brain-cognition associations were validated in independent cohorts with major depressive disorder (n=60), mild cognitive impairment (n=291), and Alzheimer's disease (n=77).