Dynamic reconfiguration of brain activity states in peritoneal dialysis patients: a Hidden Markov Model study

Cognitive decline is prevalent among peritoneal dialysis (PD) patients, but its neural mechanisms underlying resting-state latent brain state dynamics remain unclear. This study used Hidden Markov Model (HMM) to compare latent brain activity dynamics between PD patients and healthy controls (HC), and further explore their correlations with cognitive function. Resting‑state fMRI data from 50 PD patients and 46 matched HC were analyzed.

Fractional occupancy, switching rate and transition probabilities derived from HMM were compared between groups, followed by correlation and logistic regression analyses. Six latent brain states were identified. PD patients had higher occupancy of States 1, 2, 4, 6 and lower occupancy of States 3, 5 (FDR-corrected P