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Chen J, Zhou X, Yuan XL, Xu J, Zhang X, Duan X. Causal association among glaucoma, cerebral cortical structures, and Alzheimer's disease: insights from genetic correlation and Mendelian randomization. Cereb Cortex 2024; 34:bhae385. [PMID: 39323397 DOI: 10.1093/cercor/bhae385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 06/26/2024] [Accepted: 09/04/2024] [Indexed: 09/27/2024] Open
Abstract
Glaucoma and Alzheimer's disease are critical degenerative neuropathies with global impact. Previous studies have indicated that glaucomatous damage could extend beyond ocular structures, leading to brain alterations potentially associated with Alzheimer's disease risk. This study aimed to explore the causal associations among glaucoma, brain alterations, and Alzheimer's disease. We conducted a comprehensive investigation into the genetic correlation and causality between glaucoma, glaucoma endophenotypes, cerebral cortical surficial area and thickness, and Alzheimer's disease (including late-onset Alzheimer's disease, cognitive performance, and reaction time) using linkage disequilibrium score regression and Mendelian randomization. This study showed suggestive genetic correlations between glaucoma, cortical structures, and Alzheimer's disease. The genetically predicted all-caused glaucoma was nominally associated with a decreased risk of Alzheimer's disease (OR = 0.96, 95% CI: 0.93-0.99, P = 0.013). We found evidence for suggestive causality between glaucoma (endophenotypes) and 20 cortical regions and between 29 cortical regions and Alzheimer's disease (endophenotypes). Four cortical regions were causally associated with cognitive performance or reaction time at a significant threshold (P < 6.2E-04). Thirteen shared cortical regions between glaucoma (endophenotypes) and Alzheimer's disease (endophenotypes) were identified. Our findings complex causal relationships among glaucoma, cerebral cortical structures, and Alzheimer's disease. More studies are required to clarify the mediation effect of cortical alterations in the relationship between glaucoma and Alzheimer's disease.
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Affiliation(s)
- Jiawei Chen
- Aier Academy of Ophthalmology, Central South University, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Department of Glaucoma, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
| | - Xiaoyu Zhou
- Department of Glaucoma, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
| | - Xiang-Ling Yuan
- Aier Academy of Ophthalmology, Central South University, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Aier Eye Institute, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
| | - Jiahao Xu
- Department of Glaucoma, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
| | - Xinyue Zhang
- Department of Glaucoma, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
| | - Xuanchu Duan
- Aier Academy of Ophthalmology, Central South University, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Department of Glaucoma, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
- Aier Glaucoma Institute, Hunan Engineering Research Center for Glaucoma with Artificial Intelligence in Diagnosis and Application of New Materials, Changsha Aier Eye Hospital, No. 188 South Furong Road, Tianxin District, Changsha 410015, Hunan, P.R. China
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Diaz-Torres S, He W, Thorp J, Seddighi S, Mullany S, Hammond CJ, Hysi PG, Pasquale LR, Khawaja AP, Hewitt AW, Craig JE, Mackey DA, Wiggs JL, van Duijn C, Lupton MK, Ong JS, MacGregor S, Gharahkhani P. Disentangling the genetic overlap and causal relationships between primary open-angle glaucoma, brain morphology and four major neurodegenerative disorders. EBioMedicine 2023; 92:104615. [PMID: 37201334 PMCID: PMC10206164 DOI: 10.1016/j.ebiom.2023.104615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 04/21/2023] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
BACKGROUND Primary open-angle glaucoma (POAG) is an optic neuropathy characterized by progressive degeneration of the optic nerve that leads to irreversible visual impairment. Multiple epidemiological studies suggest an association between POAG and major neurodegenerative disorders (Alzheimer's disease, amyotrophic lateral sclerosis, frontotemporal dementia, and Parkinson's disease). However, the nature of the overlap between neurodegenerative disorders, brain morphology and glaucoma remains inconclusive. METHOD In this study, we performed a comprehensive assessment of the genetic and causal relationship between POAG and neurodegenerative disorders, leveraging genome-wide association data from studies of magnetic resonance imaging of the brain, POAG, and four major neurodegenerative disorders. FINDINGS This study found a genetic overlap and causal relationship between POAG and its related phenotypes (i.e., intraocular pressure and optic nerve morphology traits) and brain morphology in 19 regions. We also identified 11 loci with a significant local genetic correlation and a high probability of sharing the same causal variant between neurodegenerative disorders and POAG or its related phenotypes. Of interest, a region on chromosome 17 corresponding to MAPT, a well-known risk locus for Alzheimer's and Parkinson's disease, was shared between POAG, optic nerve degeneration traits, and Alzheimer's and Parkinson's diseases. Despite these local genetic overlaps, we did not identify strong evidence of a causal association between these neurodegenerative disorders and glaucoma. INTERPRETATION Our findings indicate a distinctive and likely independent neurodegenerative process for POAG involving several brain regions although several POAG or optic nerve degeneration risk loci are shared with neurodegenerative disorders, consistent with a pleiotropic effect rather than a causal relationship between these traits. FUNDING PG was supported by an NHMRC Investigator Grant (#1173390), SM by an NHMRC Senior Research Fellowship and an NHMRC Program Grant (APP1150144), DM by an NHMRC Fellowship, LP is funded by the NEIEY015473 and EY032559 grants, SS is supported by an NIH-Oxford Cambridge Fellowship and NIH T32 grant (GM136577), APK is supported by a UK Research and Innovation Future Leaders Fellowship, an Alcon Research Institute Young Investigator Award and a Lister Institute for Preventive Medicine Award.
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Affiliation(s)
- Santiago Diaz-Torres
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia.
| | - Weixiong He
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jackson Thorp
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Sahba Seddighi
- Nuffield Department of Population Health, Oxford University, Oxford, UK; Medical Scientist Training Program, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sean Mullany
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - Christopher J Hammond
- Departments of Ophthalmology & Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Pirro G Hysi
- Departments of Ophthalmology & Twin Research and Genetic Epidemiology, King's College London, London, UK
| | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Alex W Hewitt
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Jamie E Craig
- Department of Ophthalmology, Flinders University, Flinders Medical Centre, Bedford Park, Australia
| | - David A Mackey
- Centre for Ophthalmology and Visual Science, University of Western Australia, Lions Eye Institute, Australia
| | - Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Boston, 02114, MA, USA
| | | | - Michelle K Lupton
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Jue-Sheng Ong
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Stuart MacGregor
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia
| | - Puya Gharahkhani
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia; Faculty of Medicine, University of Queensland (UQ), Brisbane, QLD, Australia; School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, Australia.
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Deery HA, Di Paolo R, Moran C, Egan GF, Jamadar SD. The older adult brain is less modular, more integrated, and less efficient at rest: A systematic review of large-scale resting-state functional brain networks in aging. Psychophysiology 2023; 60:e14159. [PMID: 36106762 PMCID: PMC10909558 DOI: 10.1111/psyp.14159] [Citation(s) in RCA: 32] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 12/23/2022]
Abstract
The literature on large-scale resting-state functional brain networks across the adult lifespan was systematically reviewed. Studies published between 1986 and July 2021 were retrieved from PubMed. After reviewing 2938 records, 144 studies were included. Results on 11 network measures were summarized and assessed for certainty of the evidence using a modified GRADE method. The evidence provides high certainty that older adults display reduced within-network and increased between-network functional connectivity. Older adults also show lower segregation, modularity, efficiency and hub function, and decreased lateralization and a posterior to anterior shift at rest. Higher-order functional networks reliably showed age differences, whereas primary sensory and motor networks showed more variable results. The inflection point for network changes is often the third or fourth decade of life. Age effects were found with moderate certainty for within- and between-network altered patterns and speed of dynamic connectivity. Research on within-subject bold variability and connectivity using glucose uptake provides low certainty of age differences but warrants further study. Taken together, these age-related changes may contribute to the cognitive decline often seen in older adults.
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Affiliation(s)
- Hamish A. Deery
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
- Monash Biomedical ImagingMonash UniversityMelbourneVictoriaAustralia
| | - Robert Di Paolo
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
- Monash Biomedical ImagingMonash UniversityMelbourneVictoriaAustralia
| | - Chris Moran
- Peninsula Clinical School, Central Clinical SchoolMonash UniversityFrankstonVictoriaAustralia
- Department of Geriatric MedicinePeninsula HealthFrankstonVictoriaAustralia
| | - Gary F. Egan
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
- Monash Biomedical ImagingMonash UniversityMelbourneVictoriaAustralia
- Australian Research Council Centre of Excellence for Integrative Brain FunctionMelbourneVictoriaAustralia
| | - Sharna D. Jamadar
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
- Monash Biomedical ImagingMonash UniversityMelbourneVictoriaAustralia
- Australian Research Council Centre of Excellence for Integrative Brain FunctionMelbourneVictoriaAustralia
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Chen RB, Zhong YL, Liu H, Huang X. Machine learning analysis reveals abnormal functional network hubs in the primary angle-closure glaucoma patients. Front Hum Neurosci 2022; 16:935213. [PMID: 36092649 PMCID: PMC9450012 DOI: 10.3389/fnhum.2022.935213] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Background Primary angle-closure glaucoma (PACG) is a serious and irreversible blinding eye disease. Growing studies demonstrated that PACG patients were accompanied by vision and vision-related brain region changes. However, whether the whole-brain functional network hub changes occur in PACG patients remains unknown. Purpose The purpose of the study was to investigate the brain function network hub changes in PACG patients using the voxel-wise degree centrality (DC) method. Materials and methods Thirty-one PACG patients (21 male and 10 female) and 31 healthy controls (HCs) (21 male and 10 female) closely matched in age, sex, and education were enrolled in the study. The DC method was applied to investigate the brain function network hub changes in PACG patients. Moreover, the support vector machine (SVM) method was applied to distinguish PACG patients from HC patients. Results Compared with HC, PACG patients had significantly higher DC values in the right fusiform, left middle temporal gyrus, and left cerebelum_4_5. Meanwhile, PACG patients had significantly lower DC values in the right calcarine, right postcentral gyrus, left precuneus gyrus, and left postcentral gyrus. Furthermore, the SVM classification reaches a total accuracy of 72.58%, and the ROC curve of the SVM classifier has an AUC value of 0.85 (r = 0.25). Conclusion Our results showed that PACG patients showed widespread brain functional network hub dysfunction relative to the visual network, auditory network, default mode network, and cerebellum network, which might shed new light on the neural mechanism of optic atrophy in PACG patients.
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Affiliation(s)
- Ri-Bo Chen
- Department of Radiology, 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
| | - Hui Liu
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Xin Huang
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Xin Huang,
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5
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Liang Y, Pan YC, Shu HY, Chou XM, Ge QM, Zhang LJ, Li QY, Liang RB, Li HL, Shao Y. Characteristics of the Fractional Amplitude of Low-Frequency Fluctuation in Ocular Hypertension Patients: A Resting-State fMRI Study. Front Med (Lausanne) 2022; 8:687420. [PMID: 35479659 PMCID: PMC9037746 DOI: 10.3389/fmed.2021.687420] [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: 03/29/2021] [Accepted: 12/27/2021] [Indexed: 12/31/2022] Open
Abstract
Background The fractional amplitude of low-frequency fluctuation (fALFF) method has been underutilized in research on the pathogenesis and clinical manifestations of ocular hypertension (OH). Purpose This study uses resting state functional magnetic resonance imaging (rs-fMRI) and fALFF to investigate the nature of spontaneous brain activity in OH patients and the relationship, if any, between changes in activity and clinical features. Materials and Methods A total of 18 subjects (9 females and 9 males) with ocular hypertension (OH) and 18 healthy controls (HCs) matched for gender, age, and educational level were recruited to this study. All participants underwent an rs-fMRI scan, and spontaneous brain activity was assessed using the fALFF method. Receiver operating characteristic curves were plotted to investigate differences between OH and HC groups. Results The fALFF values of OH patients were significantly higher in the left precuneus lobe (LP), compared with the same region in controls (P < 0.05). Conversely, values in the left anterior cingulate lobe (LAC), were significantly lower (P < 0.05) in OH than in controls. However, no significant association was found between the mean fALFF values and clinical characteristics in either brain area. Conclusion High spontaneous activity in two brain areas may reflect neuropathological mechanisms underpinning visual impairment in OH patients.
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Imaging biomarkers for Alzheimer's disease and glaucoma: Current and future practices. Curr Opin Pharmacol 2022; 62:137-144. [PMID: 34995895 DOI: 10.1016/j.coph.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/06/2021] [Accepted: 12/06/2021] [Indexed: 11/22/2022]
Abstract
Glaucoma is a leading cause of blindness worldwide. Although intraocular pressure is the main risk factor for glaucoma, several intraocular pressure independent factors have been associated with the risk of developing the disease and its progression. The diagnosis of glaucoma relies on clinical features of the optic nerve, visual field test, and optical coherence tomography. However, the multidisciplinary aspect of the disease suggests that other biomarkers may be useful for the diagnosis, thus underling the importance of novel imaging techniques supporting clinicians. This review analyzes the common pathogenic mechanisms between glaucoma and Alzheimer's disease and the possible novel approaches for diagnosis and follow up.
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Arrigo A, Aragona E, Saladino A, Arrigo D, Fantaguzzi F, Battaglia Parodi M, Bandello F. Cognitive Dysfunctions in Glaucoma: An Overview of Morpho-Functional Mechanisms and the Impact on Higher-Order Visual Function. Front Aging Neurosci 2021; 13:747050. [PMID: 34690746 PMCID: PMC8526892 DOI: 10.3389/fnagi.2021.747050] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 08/27/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Glaucoma is a chronic, vision-threatening disease, and a major cause of legal blindness. The current view is no longer limited to the progressive optic nerve injury, since growing evidence strongly support the interpretation of glaucoma as a complex neurodegenerative disease. However, the precise pathogenic mechanisms leading to the onset and progression of central nervous system (CNS) impairment, and the functional consequences of this damage, are still partially understood. The main aim of this review is to provide a complete and updated overview of the current knowledge regarding the CNS involvement in glaucoma, and the possible therapeutic perspectives. Methods: We made a careful survey of the current literature reporting all the relevant findings related to the cognitive dysfunctions occurring in glaucoma, with specific remarks dedicated on the higher-order visual function impairment and the possible employment of neuroprotective agents. Results: The current literature strongly support the interpretation of glaucoma as a multifaceted chronic neurodegenerative disease, widely affecting the CNS. The cognitive impairment may vary in terms of higher-order functions involvement and in the severity of the degeneration. Although several neuroprotective agents are currently available, the development of new molecules represents a major topic of investigation for future clinical trials. Conclusions: Glaucoma earned the right to be fully considered a neurodegenerative disease. Glaucomatous patients may experience a heterogeneous set of visual and cognitive symptoms, progressively deteriorating the quality of life. Neuroprotection is nowadays a necessary therapeutic goal and a future promising way to preserve visual and cognitive functions, thus improving patients' quality of life.
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Affiliation(s)
- Alessandro Arrigo
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | - Emanuela Aragona
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | - Andrea Saladino
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | - Davide Arrigo
- School of Medicine, University of Messina, Messina, Italy
| | - Federico Fantaguzzi
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
| | | | - Francesco Bandello
- Department of Ophthalmology, Scientific Institute San Raffaele Hospital, Milan, Italy
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Nucci C, Garaci F, Altobelli S, Di Ciò F, Martucci A, Aiello F, Lanzafame S, Di Giuliano F, Picchi E, Minosse S, Cesareo M, Guerrisi MG, Floris R, Passamonti L, Toschi N. Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma. J Clin Med 2020; 9:jcm9103122. [PMID: 32992559 PMCID: PMC7600134 DOI: 10.3390/jcm9103122] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells and loss of their axons, progressively leading to blindness. Recently, glaucoma has been conceptualized as a more diffuse neurodegenerative disorder involving the optic nerve and also the entire brain. Consistently, previous studies have used a variety of magnetic resonance imaging (MRI) techniques and described widespread changes in the grey and white matter of patients. Diffusion kurtosis imaging (DKI) provides additional information as compared with diffusion tensor imaging (DTI), and consistently provides higher sensitivity to early microstructural white matter modification. In this study, we employ DKI to evaluate differences among healthy controls and a mixed population of primary open angle glaucoma patients ranging from stage I to V according to Hodapp–Parrish–Anderson visual field impairment classification. To this end, a cohort of patients affected by primary open angle glaucoma (n = 23) and a group of healthy volunteers (n = 15) were prospectively enrolled and underwent an ophthalmological evaluation followed by magnetic resonance imaging (MRI) using a 3T MR scanner. After estimating both DTI indices, whole-brain, voxel-wise statistical comparisons were performed in white matter using Tract-Based Spatial Statistics (TBSS). We found widespread differences in several white matter tracts in patients with glaucoma relative to controls in several metrics (mean kurtosis, kurtosis anisotropy, radial kurtosis, and fractional anisotropy) which involved localization well beyond the visual pathways, and involved cognitive, motor, face recognition, and orientation functions amongst others. Our findings lend further support to a causal brain involvement in glaucoma and offer alternative explanations for a number of multidomain impairments often observed in glaucoma patients.
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Affiliation(s)
- Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
- San Raffaele Cassino, 03043 Frosinone, Italy
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Simone Altobelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Maria Giovanna Guerrisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, 20090 Milano, Italy
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, 149 13th Street, Boston, MA 02129, USA
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Di Ciò F, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Guerrisi MG, Floris R, Nucci C, Toschi N. Reorganization of the structural connectome in primary open angle Glaucoma. Neuroimage Clin 2020; 28:102419. [PMID: 33032067 PMCID: PMC7552094 DOI: 10.1016/j.nicl.2020.102419] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 12/18/2022]
Abstract
Primary open angle Glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have suggested the hypothesis that POAG is also a central nervous system disorder which may result in additional (i.e., extra-ocular) involvement. The aim of this study is to assess possible structural, whole-brain connectivity alterations in POAG patients. We evaluated 23 POAG patients and 15 healthy controls by combining multi-shell diffusion weighted imaging, multi-shell, multi-tissue probabilistic tractography, graph theoretical measures and a recently designed 'disruption index', which evaluates the global reorganization of brain networks. We also studied the associations between the whole-brain structural connectivity measures and indices of visual acuity including the field index (VFI) and two Optical Coherence Tomography (OCT) parameters, namely the Macula Ganglion Cell Layer (MaculaGCL) and Retinal Nerve Fiber Layer (RNFL) thicknesses. We found both global and local structural connectivity differences between POAG patients and controls, which extended well beyond the primary visual pathway and were localized in the left calcarine gyrus (clustering coefficient p = 0.036), left lateral occipital cortex (clustering coefficient p = 0.017, local efficiency p = 0.035), right lingual gyrus (clustering coefficient p = 0.009), and right paracentral lobule (clustering coefficient p = 0.009, local efficiency p = 0.018). Group-wise (clustering coefficient, p = 6.59∙10-7 and local efficiency p = 6.23·10-8) and subject-wise disruption indices (clustering coefficient, p = 0.018 and local efficiency, p = 0.01) also differed between POAG patients and controls. In addition, we found negative associations between RNFL thickness and local measures (clustering coefficient, local efficiency and strength) in the right amygdala (local efficiency p = 0.008, local strength p = 0.016), right inferior temporal gyrus (clustering coefficient p = 0.036, local efficiency p = 0.042), and right temporal pole (local strength p = 0.008). Overall, we show, in patients with POAG, a whole-brain structural reorganization that spans across a variety of brain regions involved in visual processing, motor control, and emotional/cognitive functions. We also identified a pattern of brain structural changes in relation to POAG clinical severity. Taken together, our findings support the hypothesis that the reduction in visual acuity from POAG can be driven by a combination of local (i.e., in the eye) and more extended (i.e., brain) effects.
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Affiliation(s)
- Francesco Di Ciò
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy.
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; San Raffaele Cassino, Frosinone, Italy
| | - Silvia Minosse
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Giovanna Guerrisi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA.
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10
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Martucci A, Cesareo M, Toschi N, Garaci F, Bagetta G, Nucci C. Brain networks reorganization and functional disability in glaucoma. PROGRESS IN BRAIN RESEARCH 2020; 257:65-76. [PMID: 32988473 DOI: 10.1016/bs.pbr.2020.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Glaucoma is an optic neuropathy characterized by progressive loss of retinal ganglion cells with associated structural and functional changes of the optic nerve head and retinal nerve fiber layer. However, recent studies employing advanced neuroimaging techniques confirmed that glaucomatous damage is not limited to the eye but extends to the brain, affecting it also beyond the central visual pathways and disrupting brain network organization. We therefore posit that, while visual field changes play an important role in glaucoma-induced disability, central nervous pathways and mechanisms may play an important role in sustaining functional and daily living disability caused by the disease. Here we to summarize the current state of the art on the involvement of central brain circuits and possibly related disabilities in patients with glaucoma.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; San Raffaele Cassino, Frosinone, Cassino, Italy
| | - Giacinto Bagetta
- Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Rende, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
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11
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Wang R, Tang Z, Liu T, Sun X, Wu L, Xiao Z. Altered spontaneous neuronal activity and functional connectivity pattern in primary angle-closure glaucoma: a resting-state fMRI study. Neurol Sci 2020; 42:243-251. [PMID: 32632634 DOI: 10.1007/s10072-020-04577-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022]
Abstract
PURPOSE To explore the alterations of spontaneous neuronal activity and functional connectivity pattern using fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity (FC) in patients with primary angle-closure glaucoma (PACG) and fALFF relationship with the glaucoma clinical indices. MATERIALS AND METHODS Forty-two PACG patients and 21 normal controls were enrolled in this study. Resting-state functional magnetic resonance imaging was firstly analyzed by fALFF and brain regions with altered fALFF between groups were selected as seeds for the further FC analysis. The relationships between fALFF/FC values of abnormal regions and ophthalmological measures, including mean deviation of visual field (MDVF) and retinal nerve fiber layer (RNFL) thickness, were also analyzed. RESULTS Compared with NC, PACG had significant lower fALFF values in the left cuneus, left middle temporal gyrus, right middle temporal gyrus, and right precentral gyrus, while higher fALFF values in the bilateral superior frontal gyrus (P < 0.05 after correction). Furthermore, PACG showed increased FC between left cuneus and bilateral superior frontal gyrus/bilateral posterior cingulate gyrus; between left middle temporal gyrus and bilateral superior frontal gyrus; and between right middle temporal gyrus and bilateral insular (P < 0.05 after correction). In addition, in the PACG group, the mean fALFF values of the left cuneus were positively correlated with MDVF (R = 0.419, P = 0.005) and RNFL thickness (R = 0.322, P = 0.038). Meanwhile, the mean fALFF values of bilateral superior frontal gyrus were negatively correlated with MDVF (R = - 0.454, P = 0.003) and RNFL thickness (R = - 0.556, P < 0.001). CONCLUSIONS PACG exhibited abnormal spontaneous neural activity and connectivity in several brain regions mainly associated with visual and visual-related functions. In addition, the fALFF values of the left cuneus and bilateral superior frontal gyrus may be complementary biomarkers for assessing the disease severity.
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Affiliation(s)
- Rong Wang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Shanghai Institute of Medical Imaging, Fudan University, Shanghai, 200031, China.,Department of Radiology, HuaShan Hospital of Shanghai Medical School, Fudan University, Shanghai, 200030, China
| | - Zuohua Tang
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
| | - Tingting Liu
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital of Shanghai Medical School, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, NHFPC, Fudan University, Shanghai, 200031, China.,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200031, China
| | - Xinghuai Sun
- Department of Ophthalmology & Visual Science, Eye & ENT Hospital of Shanghai Medical School, State Key Laboratory of Medical Neurobiology, Institutes of Brain Science, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,Key Laboratory of Myopia, NHFPC, Fudan University, Shanghai, 200031, China. .,Shanghai Key Laboratory of Visual Impairment and Restoration, Fudan University, Shanghai, 200031, China.
| | - Lingjie Wu
- Department of Otolaryngology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, Shanghai, 200031, China
| | - Zebin Xiao
- Department of Radiology, Eye & ENT Hospital of Shanghai Medical School, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
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