Abstract: Objective  To explore the neural mechanisms of cognitive decline of sub-health people with kidney deficiency syndrome. Methods  A total of 35 sub-health subjects with kidney deficiency syndrome and 35 matched healthy subjects were recruited in this study. They were assessed with Repeatable Battery for the Assessment of Neuropsychological Status(RBANS), clinical assessment and resting-state functional magnetic resonance imaging scan. Based on a cortical surface-based analysis, the values of amplitude of low frequency fluctuations(ALFF) and fractional ALFF(fALFF) was calculated. Furthermore, the relationships between abnormal functional activity in brain areas, cognitive function and clinical symptoms were analyzed. Results  Compared with healthy subjects, sub-health subjects with kidney deficiency syndrome showed significantly lower scores of immediate memory index, attention index, and total scale index.The brain regions with abnormal changed ALFF/fALFF values mainly included the left primary visual cortex, the left dorsal occipital cortex, and the right supplementary motor area. Moreover, the ALFF values of the left dorsal occipital and the right frontal eye fields as well the fALFF values of the left primary visual cortex were positively correlated with kidney deficiency scores.The ALFF values of the right frontal eye fields and the fALFF values of the right supplementary motor area were negatively correlated with total scores of RBANS. Conclusion  Impaired memory and attentional functions of were observed in sub-health subjects with kidney deficiency syndrome. The changed neural activity in multiple brain regions, including the left occipital lobe and the right frontal lobe, might be the underlying neural mechanism for declined cognitive function.

Key words: kidney deficiency, sub-health, resting-state functional magnetic resonance imaging, amplitude of low frequency fluctuations, fractional amplitude of low frequency fluctuations, Repeatable Battery for the Assessment of Neuropsychological Status