PONE-D-24-00628End-stage renal disease accompanied by mild cognitive impairment: A study and analysis of trimodal brain network fusionPLOS ONE

Dear Dr. Shi,

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Academic Editor

PLOS ONE

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Additional Editor Comments:

Please address the below queries

Major comments

1)In introduction you state “Investigating the relationship between changes in brain functional networks and MCI in patients with ESRD is an area of active research interest [17]” …Reference [17] has no mention of ESRD?

2)You introduce “mode of brain network” with this sentence “The utilization of multimodal fusion methods can offer more comprehensive and accurate brain information, revealing correlations between different modes of BN” what does mode mean here

3)Add a citation for Montreal Cognitive Assessment (MoCA)..Also typo in reference 27.

4)What is b0 image? what is FN? What is HMR?

5)Reference for “A deterministic fiber bundle tracking algorithm was employed, with tracking parameters set as anisotropy index < 0.15 and tracking angle < 45° to calculate indicators such as FN between brain regions”

6)Section 2.3.3, references missing for first 6 lines.

7)C is correlation matrix and also point edge association matrix?

8)Figures are of poor quality...so please include better quality ones

Minor comments

1)Check English in below sentences.

a) It offers a powerful representation of the patterns of interaction between different regions of brain.

b) We are able to obtain information that can identify individual participants.

c)Numerous other typos and grammatical errors also exists. please check the entire paper.

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

Reviewer #3: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: 1. Compared with the existing state-of-the-art methods, what are the core innovations in your work?

2. The Abstract should be more concise.

3. There are too many processes and methods introduced in section 2.1 and 2.2, and these are not your main work.

4. The attached figures look a little blurry and needs to be replaced with a clearer version.

Reviewer #2: In this research paper, the authors delve into the examination of alterations in individuals grappling with end-stage renal disease, especially those presenting with mild cognitive impairment. They introduce a model featuring a multi-head self-attention mechanism to amalgamate brain functional networks, white matter structural networks, and gray matter structural networks. This integration culminates in the formation of brain fusion networks.

The study is potentially interesting, the methods are sounding to me, the work seems well performed and sufficiently detailed, the figures and tables are clear.

Some points remain to be clarified:

Reference for sentence “Epidemiological surveys indicate that cognitive dysfunction is highly prevalent among ESRD patients, with conservative estimates suggesting that 16% to 38% of them experience cognitive impairment.”

In my opinion the sentence “Mild cognitive impairment (MCI) serves as an intermediate stage between normal cognitive function and cognitive dysfunction.” could be improved to “Mild cognitive impairment (MCI) represents the intermediate stage between the normal decline in memory and thinking associated with aging and the more pronounced cognitive deterioration observed in dementia.

Add references in the sentence “These techniques include functional magnetic resonance imaging (fMRI) [6], structural magnetic resonance imaging [7], magnetic resonance spectroscopy [8], fluorodeoxyglucose positron emission tomography [9], single photon emission tomography [10], arterial spin labeling [11], diffusion tensor imaging [12], and diffusion kurtosis imaging (DKI) [13]”

The sample sizes of the two groups are not well balanced. There are much fewer controls than MCI subjects.

In the discussion the authors should add the strengths.

Reviewer #3: This manuscript utilized a multi-head self-attention mechanism to fuse brain functional networks, white matter structural networks, and gray matter structural networks, and constructed brain fusion networks (FBN). FBN is employed in the diagnosis and prediction of ESRDaMCI to evaluate its classification performance and investigate the correlation between discriminative brain regions and cognitive dysfunction. This method identifies brain regions that exhibit significant correlations with MoCA scale scores, providing insights into the underlying mechanisms of ESRDaMCI. The content of the manuscript is well-organized, the methods they used is novelty. There are some minor problems need to be addressed:

1.The title of the figures should not appeared separately in the manuscript.

2.Figure legends should be added and listed at the end of the References.

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Reviewer #1: No

Reviewer #2: Yes: Daniele Corbo

Reviewer #3: No

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End-stage renal disease accompanied by mild cognitive impairment: A study and analysis of trimodal brain network fusion

PONE-D-24-00628R1

Dear Dr. Shi,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

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Kind regards,

Cota Navin Gupta

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Good work in addressing the reviewer comments

Reviewers' comments: