Investigation of changes in activity and function in acute unilateral open globe injury-associated brain regions based on percent amplitude of fluctuation method: a resting-state functional MRI study

Anxiety and Depression after Traumatic Open-Globe Injury

Introduction

This cross-sectional interview-based study aimed to assess the prevalence and severity of probable anxiety and depression in patients with traumatic open-globe injury and to identify factors associated with anxiety and depression following open-globe injury.

Methods

Two hundred and twenty-five patients with open-globe injury were identified at the UC Davis Medical Center between 2008 and 2019. Prisoners and patients under 18 at the time of recruitment were excluded from the study. One hundred and twenty-four patients provided consent to participate in the study, which involved a phone interview and chart review. The interview consisted of a section on sociodemographic data and potential associations followed by the Hospital Anxiety and Depression Scale, a standardized 14-question survey that has been validated in previous studies as an excellent predictor of anxiety and depression. A score of 8 for anxiety or depression was considered a positive test, and patients with a positive test in either category were advised to seek further evaluation with their primary care doctors. The prevalence of probable anxiety and depression was calculated, and linear regression was used to identify factors associated with anxiety and depression.

Results

The average age was 50.5 ± 19.2, and 75.8% of patients were male. The anxiety score was positive in 37.9% of patients and the depression score was positive in 28.2%. The mean anxiety and depression scores were 6.3 ± 4.7 and 5.5 ± 4.8, respectively. The P value of the linear regressions for anxiety score and depression score were both < 0.001, with R2 = 0.429 and 0.363, respectively. Younger age (P = 0.002) and unemployment at the time of the interview (P = 0.038) were associated with higher anxiety scores. Patients who were bothered by the appearance of their injured eye had higher anxiety scores (P < 0.001) and depression scores (P < 0.001). Patients without a high school diploma had higher depression scores (P < 0.001). Gender, enucleation status, number of people in support network, use of a prosthetic or scleral shell, final logMAR visual acuity, marital status, months since the initial injury, and presence of an intraocular foreign body were not significantly associated with anxiety or depression scores.

Conclusions

Traumatic open-globe injury is associated with a high prevalence of probable anxiety and depression. Dissatisfaction with the appearance of the injured eye was associated with higher anxiety and depression scores. Younger age and unemployment were associated with increased anxiety scores, and lack of a high school diploma was associated with higher depression scores.

Investigation of Altered Spontaneous Brain Activities in Patients With Moyamoya Disease Using Percent Amplitude of Fluctuation Method: A Resting-State Functional MRI Study

Background: Moyamoya disease (MMD) is a chronic progressive cerebrovascular abnormality characterized by chronic occlusion of large intracranial vessels with smoky vascular development at the base of the skull. In patients with MMD, abnormal spontaneous brain activity would be expected. Purpose: To assess the brain activity changes in patients with MMD by resting-state functional MRI (rs-fMRI), using the percent amplitude of fluctuation (PerAF) analysis method. Materials and Methods: A total of 17 patients with MMD (3 males and 14 females) and 17 healthy control (HC) subjects with matched gender and age were recruited for this study. We used rs-fMRI to scan all the patients with MMD. Spontaneous neural activity was evaluated using the PerAF approach. The receiver operating characteristic (ROC) curve analysis was used to assess the ability of the PerAF to distinguish patients with MMD from HCs. The Hospital Anxiety and Depression Scale (HADS) tests were performed to assess the emotional status of patients with MMD and retinal nerve fiber layer thickness (RNFLT) was measured using high-resolution optical coherence tomography (hr-OCT). The relationship between the HADS scores, RNFLT values, and the PerAF signals was assessed using the Pearson's correlation analysis. Results: Compared with HCs, the PerAF signals in patients with MMD were decreased in the Frontal_Sup_Medial_R and Precentral_L, whereas those in the Caudate_L were increased. The areas under the ROC curves indicated that signals in these brain regions could distinguish between patients with MMD and HCs. The PerAF value of Frontal_Sup_Medial_R was positively correlated with the left and right eye RNFLT values and negatively correlated with the HADS scores. Conclusion: In patients with MMD, reduced PerAF signals in the Frontal_Sup_Medial_R, Precentral_L, and Caudate_L may be associated with psychiatric diseases including anxiety and depression and decreased RNFLT may be associated with ophthalmic complications due to the compression of terminal branches of the internal carotid artery in the retinal fiber layer. The PerAF can be used as an effective indicator of ocular complications of MMD and to study the neural mechanism underpinning emotional complications in patients with MMD.