1
|
Beyer R, Al-Nosairy KO, Freitag C, Stolle FH, Behrens M, Prabhakaran GT, Thieme H, Schega L, Hoffmann MB. Treadmill-walking impairs visual function in early glaucoma and elderly controls. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06530-w. [PMID: 38856953 DOI: 10.1007/s00417-024-06530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/09/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024] Open
Abstract
AIMS Impaired vision is an additional risk factor in elderly for falls. We investigated the hypothesis that treadmill (TM) walking affects visual function in both healthy elderly and those with early-moderate visual dysfunction due to glaucoma. METHODS Thirty healthy controls (HC) aged 64-83 years and 18 glaucoma patients (GLA) aged 62-82 years participated in this cross-sectional study. The impact of TM-walking on visual function was assessed binocularly for (i) best-corrected visual acuity (BCVA) with and without crowding effect, (ii) contrast sensitivity (CS), and (iii) and visual field (mean deviation, VF-MD). Visual function was tested while participants were standing or during TM-walking for 2 speed conditions: (i) fast walking at their preferred speed and (ii) walking at a fixed speed of 3.5 km/h. RESULTS GLA, most with early-moderate VF loss, performed equally well as HC. Independent of GROUP, an impact of SPEED on visual functions was statistically evident with large statistical effect size for (i) both types of BCVA with a mean loss of 0.02-0.05 logMAR (η2 = 0.41) and (ii) VF-MD with mean loss of 1 dB (η2 = 0.70), but not for CS. CONCLUSIONS Here, we introduce a paradigm for the assessment of visual function during walking. We provide proof-of-concept that our approach allows for the identification of walking induced visual function loss, i.e., a deterioration of BCVA and VF-sensitivity during TM-walking in both groups. It is therefore of promise for the investigation of the relation of vision impairment and mobility, ultimately the increased frequency of falls in advanced glaucoma.
Collapse
Affiliation(s)
- Rosalie Beyer
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Khaldoon O Al-Nosairy
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Constantin Freitag
- Department of Sport Science, Institute III, Otto Von Guericke University Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Francie H Stolle
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto Von Guericke University Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
- University of Applied sciences for Sport and Management Potsdam, Olympischer Weg 7, 14471, Potsdam, Germany
| | - Gokulraj T Prabhakaran
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Hagen Thieme
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto Von Guericke University Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Michael B Hoffmann
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
- Center for Behavioral Brain Research, Magdeburg, Germany.
| |
Collapse
|
2
|
Kruper J, Richie-Halford A, Benson NC, Caffarra S, Owen J, Wu Y, Egan C, Lee AY, Lee CS, Yeatman JD, Rokem A. Convolutional neural network-based classification of glaucoma using optic radiation tissue properties. COMMUNICATIONS MEDICINE 2024; 4:72. [PMID: 38605245 PMCID: PMC11009254 DOI: 10.1038/s43856-024-00496-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Sensory changes due to aging or disease can impact brain tissue. This study aims to investigate the link between glaucoma, a leading cause of blindness, and alterations in brain connections. METHODS We analyzed diffusion MRI measurements of white matter tissue in a large group, consisting of 905 glaucoma patients (aged 49-80) and 5292 healthy individuals (aged 45-80) from the UK Biobank. Confounds due to group differences were mitigated by matching a sub-sample of controls to glaucoma subjects. We compared classification of glaucoma using convolutional neural networks (CNNs) focusing on the optic radiations, which are the primary visual connection to the cortex, against those analyzing non-visual brain connections. As a control, we evaluated the performance of regularized linear regression models. RESULTS We showed that CNNs using information from the optic radiations exhibited higher accuracy in classifying subjects with glaucoma when contrasted with CNNs relying on information from non-visual brain connections. Regularized linear regression models were also tested, and showed significantly weaker classification performance. Additionally, the CNN was unable to generalize to the classification of age-group or of age-related macular degeneration. CONCLUSIONS Our findings indicate a distinct and potentially non-linear signature of glaucoma in the tissue properties of optic radiations. This study enhances our understanding of how glaucoma affects brain tissue and opens avenues for further research into how diseases that affect sensory input may also affect brain aging.
Collapse
Affiliation(s)
- John Kruper
- Department of Psychology, University of Washington, Seattle, WA, USA
- eScience Institute, University of Washington, Seattle, WA, USA
| | - Adam Richie-Halford
- Graduate School of Education and Division of Developmental Behavioral Pediatrics, Stanford University, Stanford, CA, USA
| | - Noah C Benson
- eScience Institute, University of Washington, Seattle, WA, USA
| | - Sendy Caffarra
- Graduate School of Education and Division of Developmental Behavioral Pediatrics, Stanford University, Stanford, CA, USA
- University of Modena and Reggio Emilia, Modena, Italy
| | - Julia Owen
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Roger and Angie Karalis Johnson Retina Center, Seattle, WA, USA
| | - Yue Wu
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Roger and Angie Karalis Johnson Retina Center, Seattle, WA, USA
| | | | - Aaron Y Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Roger and Angie Karalis Johnson Retina Center, Seattle, WA, USA
| | - Cecilia S Lee
- Department of Ophthalmology, University of Washington, Seattle, WA, USA
- Roger and Angie Karalis Johnson Retina Center, Seattle, WA, USA
| | - Jason D Yeatman
- Graduate School of Education and Division of Developmental Behavioral Pediatrics, Stanford University, Stanford, CA, USA
| | - Ariel Rokem
- Department of Psychology, University of Washington, Seattle, WA, USA.
- eScience Institute, University of Washington, Seattle, WA, USA.
| |
Collapse
|
3
|
Cooper AC, Tchernykh M, Shmuel A, Mendola JD. Diffusion tensor imaging of optic neuropathies: a narrative review. Quant Imaging Med Surg 2024; 14:1086-1107. [PMID: 38223128 PMCID: PMC10784057 DOI: 10.21037/qims-23-779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/21/2023] [Indexed: 01/16/2024]
Abstract
Background and Objective Diffusion tensor imaging (DTI) has been implemented in a breadth of scientific investigations of optic neuropathies, though it has yet to be fully adopted for diagnosis or prognosis. This is potentially due to a lack of standardization and weak replication of results. The aim of this investigation was to review DTI results from studies specific to three distinct optic neuropathies in order to probe its current clinical utility. Methods We reviewed the DTI literature specific to primary open-angle glaucoma (POAG), optic neuritis (ON), and traumatic optic neuropathy (TON) by systematically searching the PubMed database on March 1st, 2023. Four distinct DTI metrics are considered: fractional anisotropy (FA), along with mean diffusivity (MD, axial diffusivity (AD), and radial diffusivity (RD). Results from within-group, between-group, and correlational studies were thoroughly assessed. Key Content and Findings POAG studies most consistently report a decrease in FA, especially in the optic radiations, followed in prevalence by an increase in RD and then MD, whilst AD yields conflicting results between studies. It is notable that there is not an equal distribution of investigated DTI metrics, with FA utilized the most, followed by MD, RD, and AD. Studies of ON are similar in that the most consistent findings are specific to FA, RD, and MD. These results are specific to the optic nerve and radiation since only one study measured the intermediary regions. More studies are needed to assess the effect that ON has on the tracts of the visual system. Finally, only three studies assessing DTI of TON have been performed to date, displaying low to moderate replicability of results. To improve the level of agreement between studies assessing each optic neuropathy, an increased level of standardization is recommended. Conclusions Both POAG and ON studies have yielded some prevalent DTI findings, both for contrast and correlation-based assessments. Although the clinical need is high for TON, considering the limitations of the current diagnostic tools, too few studies exist to make confident conclusions. Future use of standardized and longitudinal DTI, along with the foreseen methodological and technical improvements, is warranted to effectively study optic neuropathies.
Collapse
Affiliation(s)
- Austin C. Cooper
- McGill Vision Research and Department of Ophthalmology, McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | - Maxim Tchernykh
- McGill Vision Research and Department of Ophthalmology, McGill University, Montréal, QC, Canada
| | - Amir Shmuel
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
- Departments of Physiology and Biomedical Engineering, McGill University, Montreal, QC, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Janine D. Mendola
- McGill Vision Research and Department of Ophthalmology, McGill University, Montréal, QC, Canada
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| |
Collapse
|
4
|
Fu Q, Liu H, Zhong YL. The Predictive Values of Changes in Local and Remote Brain Functional Connectivity in Primary Angle-Closure Glaucoma Patients According to Support Vector Machine Analysis. Front Hum Neurosci 2022; 16:910669. [PMID: 35664342 PMCID: PMC9160336 DOI: 10.3389/fnhum.2022.910669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/26/2022] [Indexed: 12/30/2022] Open
Abstract
Purpose The primary angle-closure glaucoma (PACG) is an irreversible blinding eye disease in the world. Previous neuroimaging studies demonstrated that PACG patients were associated with cerebral changes. However, the effect of optic atrophy on local and remote brain functional connectivity in PACG patients remains unknown. Materials and Methods In total, 23 patients with PACG and 23 well-matched Health Controls (HCs) were enrolled in our study and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. The regional homogeneity (ReHo) method and functional connectivity (FC) method were used to evaluate the local and remote brain functional connectivity. Moreover, support vector machine (SVM) method was applied to constructing PACG classification model. Results Compared with the HC, PACG patients showed increased ReHo values in right cerebellum (CER)_8, left CER_4-5, and right CER_8. In contrast, PACG patients showed decreased ReHo values in the bilateral lingual gyrus (LING)/calcarine (CAL)/superior occipital gyrus (SOG) and right postcentral gyrus (PostCG). The ReHo value exhibited an accuracy of 91.30% and area under curve (AUC) of 0.95 for distinguishing the PACG patients from HC. Conclusion Our study demonstrated that the PACG patients showed abnormal ReHo value in the cerebellum, visual cortex, and supplementary motor area, which might be reflect the neurological mechanisms underlying vision loss and eye pain in PACG patients. Moreover, the ReHo values can be used as a useful biomarker for distinguishing the PACG patients from HCs.
Collapse
Affiliation(s)
- Qiang Fu
- Department of Emergency, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Hui Liu
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yu Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Yu Lin Zhong,
| |
Collapse
|
5
|
Haykal S, Invernizzi A, Carvalho J, Jansonius NM, Cornelissen FW. Microstructural Visual Pathway White Matter Alterations in Primary Open-Angle Glaucoma: A Neurite Orientation Dispersion and Density Imaging Study. AJNR Am J Neuroradiol 2022; 43:756-763. [PMID: 35450857 PMCID: PMC9089264 DOI: 10.3174/ajnr.a7495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 02/26/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE DTI studies of patients with primary open-angle glaucoma have demonstrated that glaucomatous degeneration is not confined to the retina but involves the entire visual pathway. Due to the lack of direct biologic interpretation of DTI parameters, the structural nature of this degeneration is still poorly understood. We used neurite orientation dispersion and density imaging (NODDI) to characterize the microstructural changes in the pregeniculate optic tracts and the postgeniculate optic radiations of patients with primary open-angle glaucoma, to better understand the mechanisms underlying these changes. MATERIALS AND METHODS T1- and multishell diffusion-weighted scans were obtained from 23 patients with primary open-angle glaucoma and 29 controls. NODDI parametric maps were produced from the diffusion-weighted scans, and probabilistic tractography was used to track the optic tracts and optic radiations. NODDI parameters were computed for the tracked pathways, and the measures were compared between both groups. The retinal nerve fiber layer thickness and visual field loss were assessed for the patients with glaucoma. RESULTS The optic tracts of the patients with glaucoma showed a higher orientation dispersion index and a lower neurite density index compared with the controls (P < .001 and P = .001, respectively), while their optic radiations showed a higher orientation dispersion index only (P = .003). CONCLUSIONS The pregeniculate visual pathways of the patients with primary open-angle glaucoma exhibited a loss of both axonal coherence and density, while the postgeniculate pathways exhibited a loss of axonal coherence only. Further longitudinal studies are needed to assess the progression of NODDI alterations in the visual pathways of patients with primary open-angle glaucoma across time.
Collapse
Affiliation(s)
- S Haykal
- From the Laboratory for Experimental Ophthalmology (S.H., A.I., J.C., F.W.C.)
| | - A Invernizzi
- From the Laboratory for Experimental Ophthalmology (S.H., A.I., J.C., F.W.C.)
| | - J Carvalho
- From the Laboratory for Experimental Ophthalmology (S.H., A.I., J.C., F.W.C.)
| | - N M Jansonius
- Department of Ophthalmology (N.M.J.), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - F W Cornelissen
- From the Laboratory for Experimental Ophthalmology (S.H., A.I., J.C., F.W.C.)
| |
Collapse
|
6
|
Demaria G, Invernizzi A, Ombelet D, Carvalho JC, Renken RJ, Cornelissen FW. Binocular Integrated Visual Field Deficits Are Associated With Changes in Local Network Function in Primary Open-Angle Glaucoma: A Resting-State fMRI Study. Front Aging Neurosci 2022; 13:744139. [PMID: 35095465 PMCID: PMC8792402 DOI: 10.3389/fnagi.2021.744139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
In glaucoma participants, both structural and functional brain changes have been observed, but we still have insufficient understanding of how these changes also affect the integrity of cortical functional networks, and how these changes relate to visual function. This is relevant, as functional network integrity may affect the applicability of future treatments, as well as the options for rehabilitation or training. Here, we compare global and local functional connectivity in local and global brain networks between glaucoma and control participants. Moreover, we study the relationship between functional connectivity and visual field (VF) loss. For our study, 20 subjects with primary open-angle glaucoma (POAG) and 24 age-similar healthy participants were recruited to undergo an ophthalmic assessment followed by two resting-state (RS) (f)MRI scans. For each scan and for each group, the ROIs with eigenvector centrality (EC) values higher than the 95th percentile were considered the most central brain regions (“hubs”). Hubs for which we found a significant difference in EC in both scans between glaucoma and healthy participants were considered to provide evidence for network changes. In addition, we tested the notion that a brain region's hub function in POAG might relate to the severity of a participant's VF defect, irrespective of which eye contributed mostly to this. To determine this, for each participant, eye-independent scores were derived for: (1) sensitivity of the worse eye – indicating disease severity, (2) sensitivity of both eyes combined – with one eye potentially compensating for loss in the other, or (3) difference in eye sensitivity – potentially requiring additional network interactions. By correlating each of these VF scores and the EC values, we assessed whether VF defects could be associated with centrality alterations in POAG. Our results show that no functional connectivity disruptions were found at the global brain level in POAG participants. This indicates that in glaucoma global brain network communication is preserved. Furthermore, for the Lingual Gyrus, identified as a brain hub, we found a positive correlation between the EC value and the VF sensitivity of both eyes combined. The fact that reduced local network functioning is associated with reduced binocular VF sensitivity suggests the presence of local brain reorganization that has a bearing on functional visual abilities.
Collapse
Affiliation(s)
- Giorgia Demaria
- Laboratory of Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- *Correspondence: Giorgia Demaria
| | - Azzurra Invernizzi
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Daniel Ombelet
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Joana C. Carvalho
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Remco J. Renken
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Frans W. Cornelissen
- Laboratory of Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| |
Collapse
|