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Chamard C, Alonso S, Carrière I, Villain M, Arnould L, Debourdeau E, Huguet H, Mura T, Daien V. Dementia and glaucoma: Results from a Nationwide French Study between 2006 and 2018. Acta Ophthalmol 2024; 102:e754-e761. [PMID: 38247022 DOI: 10.1111/aos.16624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 12/13/2023] [Accepted: 12/19/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE Glaucoma is the leading cause of irreversible blindness worldwide. The brain and eye share many characteristics, so the eye may provide an easy-access window on brain processes. The aim of the study was to evaluate the link between glaucoma as well as intraocular pressure (IOP)-lowering drops load and all-cause dementia. METHODS This was a nested case-control study based on the French national healthcare database from 1 January 2006 to 31 December 2018in individuals aged ≥60 years. We compared cases of incident all-cause dementia with 1:5 controls matched by date of case diagnosis (index date), age, sex, and income. We set a 5-year exposure to glaucoma period ending 2 years before the index date (lag-time period to avoid protopathic bias). The main outcome was glaucoma defined with hospitalization related to POAG and/or dispensations of IOP-lowering drops. The secondary outcome was the IOP-lowering drops load. RESULTS In total, 4810 incident all-cause dementia and 24 050 matched controls were analysed (median [IQR] age 82 [10] years; 66.6% women). The prevalence of glaucoma was 14.0% in controls and cases. Risk of all-cause dementia was not associated with glaucoma (crude OR, 1.02; 95% CI [0.93-1.11]; p = 0.7; adjusted OR, 0.99; 95% CI [0.91-1.09]; p = 0.9) or IOP-lowering drops load (p = 0.2). CONCLUSION The present study in general population ≥60 years old in France did not find any association between glaucoma and incident all-cause dementia.
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Affiliation(s)
- Chloé Chamard
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
- Institute for Neurosciences of Montpellier, Univ Montpellier, INSERM, Montpellier, France
| | - Sandrine Alonso
- Department of Biostatistics, Epidemiology & Public Health, CHRU Nîmes, University of Montpellier, Nîmes, France
| | - Isabelle Carrière
- Institute for Neurosciences of Montpellier, Univ Montpellier, INSERM, Montpellier, France
| | - Max Villain
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
| | - Louis Arnould
- Department of Ophthalmology, University Hospital, Dijon, France
| | - Eloi Debourdeau
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
| | - Héléna Huguet
- Department of Biostatistics, Epidemiology & Public Health, CHU Montpellier, University of Montpellier, Montpellier, France
| | - Thibault Mura
- Department of Biostatistics, Epidemiology & Public Health, CHRU Nîmes, University of Montpellier, Nîmes, France
| | - Vincent Daien
- Department of Ophthalmology, Gui de Chauliac Hospital, Montpellier, France
- Institute for Neurosciences of Montpellier, Univ Montpellier, INSERM, Montpellier, France
- The Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
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Wang Y, Shu Y, Cai G, Guo Y, Gao J, Chen Y, Lv L, Zeng X. Altered static and dynamic functional network connectivity in primary angle-closure glaucoma patients. Sci Rep 2024; 14:11682. [PMID: 38778225 PMCID: PMC11111766 DOI: 10.1038/s41598-024-62635-6] [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: 11/23/2023] [Accepted: 05/20/2024] [Indexed: 05/25/2024] Open
Abstract
To explore altered patterns of static and dynamic functional brain network connectivity (sFNC and dFNC) in Primary angle-closure glaucoma (PACG) patients. Clinically confirmed 34 PACG patients and 33 age- and gender-matched healthy controls (HCs) underwent evaluation using T1 anatomical and functional MRI on a 3 T scanner. Independent component analysis, sliding window, and the K-means clustering method were employed to investigate the functional network connectivity (FNC) and temporal metrics based on eight resting-state networks. Differences in FNC and temporal metrics were identified and subsequently correlated with clinical variables. For sFNC, compared with HCs, PACG patients showed three decreased interactions, including SMN-AN, SMN-VN and VN-AN pairs. For dFNC, we derived four highly structured states of FC that occurred repeatedly between individual scans and subjects, and the results are highly congruent with sFNC. In addition, PACG patients had a decreased fraction of time in state 3 and negatively correlated with IOP (p < 0.05). PACG patients exhibit abnormalities in both sFNC and dFNC. The high degree of overlap between static and dynamic results suggests the stability of functional connectivity networks in PACG patients, which provide a new perspective to understand the neuropathological mechanisms of optic nerve damage in PACG patients.
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Affiliation(s)
- Yuanyuan Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yongqiang Shu
- Positron Emission Tomography (PET) Center, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Guoqian Cai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Guo
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Junwei Gao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ye Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Lianjiang Lv
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
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3
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Loskutova E, Butler JS, Setti A, O'Brien C, Loughman J. Ability to Process Multisensory Information Is Impaired in Open Angle Glaucoma. J Glaucoma 2024; 33:78-86. [PMID: 37974328 DOI: 10.1097/ijg.0000000000002331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Patients with glaucoma demonstrated deficiencies in their ability to process multisensory information when compared with controls, with those deficiencies being related to glaucoma severity. Impaired multisensory integration (MSI) may affect the quality of life in individuals with glaucoma and may contribute to the increased prevalence of falls and driving safety concerns. Therapeutic possibilities to influence cognition in glaucoma should be explored. PURPOSE Glaucoma is a neurodegenerative disease of the optic nerve that has also been linked to cognitive health decline. This study explored MSI as a function of glaucoma status and severity. METHODS MSI was assessed in 37 participants with open angle glaucoma relative to 18 age-matched healthy controls. The sound-induced flash illusion was used to assess MSI efficiency. Participants were presented with various combinations of simultaneous visual and/or auditory stimuli and were required to indicate the number of visual stimuli observed for each of the 96 total presentations. Central retinal sensitivity was assessed as an indicator of glaucoma severity (MAIA; CenterVue). RESULTS Participants with glaucoma performed with equivalent capacity to healthy controls on unisensory trials ( F1,53 =2.222, P =0.142). Both groups performed equivalently on congruent multisensory trials involving equal numbers of auditory and visual stimuli F1,53 =1.032, P =0.314). For incongruent presentations, that is, 2 beeps and 1 flash stimulus, individuals with glaucoma demonstrated a greater influence of the incongruent beeps when judging the number of flashes, indicating less efficient MSI relative to age-matched controls ( F1,53 =11.45, P <0.002). In addition, MSI performance was positively correlated with retinal sensitivity ( F3,49 =4.042, P <0.025), adjusted R ²=0.15). CONCLUSIONS Individuals with open angle glaucoma exhibited MSI deficiencies that relate to disease severity. The type of deficiencies observed were similar to those observed among older individuals with cognitive impairment and balance issues. Impaired MSI may, therefore, be relevant to the increased prevalence of falls observed among individuals with glaucoma, a concept that merits further investigation.
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Affiliation(s)
- Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Annalisa Setti
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
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Wang Q, Qu X, Wang H, Chen W, Sun Y, Li T, Chen J, Wang Y, Wang N, Xian J. Arterial spin labeling reveals disordered cerebral perfusion and cerebral blood flow-based functional connectivity in primary open-angle glaucoma. Brain Imaging Behav 2024; 18:231-242. [PMID: 38006574 PMCID: PMC10844339 DOI: 10.1007/s11682-023-00813-2] [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] [Accepted: 10/15/2023] [Indexed: 11/27/2023]
Abstract
PURPOSE Primary open-angle glaucoma (POAG) is a widespread neurodegenerative condition affecting brain regions involved in visual processing, somatosensory processing, motor control, emotional regulation and cognitive functions. Cerebral hemodynamic dysfunction contributes to the pathogenesis of glaucomatous neurodegeneration. We aimed to investigate cerebral blood flow (CBF) redistributed patterns in visual and higher-order cognitive cortices and its relationship with clinical parameters in POAG, and we hypothesized that CBF changes together across regions within the same functional network. METHODS Forty-five POAG patients and 23 normal controls underwent three-dimensional pseudocontinuous arterial spin labeling MRI to measure the resting-state CBF. Group comparisons of CBF and correlations between CBF changes and ophthalmological and neuropsychological indices were assessed. We determined CBF-based functional connectivity (CBFC) by calculating the correlations between specific regions and all other brain voxels and compared CBFC differences between groups. RESULTS The patients exhibited decreased CBF in visual cortices, postcentral gyrus, inferior parietal lobule and cerebellum and increased CBF in medial, middle, and superior frontal gyri, as well as the insula. The reduced CBF in the visual cortices positively correlated with visual field defect (r = 0.498, p = 0.001) in POAG patients, while the increased CBF in the right medial frontal gyrus was negatively associated with the visual field defect (r = -0.438, p = 0.004) and positively associated with the cup-to-disc ratio (r = 0.469, p = 0.002). POAG patients showed negative connections weakening or converting to mild positive connections, as well as positive connections converting to negative connections. CONCLUSIONS Regional and interregional CBF properties confirmed that the aberrant brain regions extend beyond the visual pathway, including the somatosensory, emotional and cognitive networks, which highlights the importance of cerebral hemodynamic dysfunction in the pathophysiology of spreading neurodegeneration in POAG.
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Affiliation(s)
- Qian Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, NO.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Xiaoxia Qu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, NO.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, NO.1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
- Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Hospital, 17 Hougou Lane, Chongwenmen, Beijing, 100005, China
| | - Weiwei Chen
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, NO.1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
- Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Hospital, 17 Hougou Lane, Chongwenmen, Beijing, 100005, China
| | - Yunxiao Sun
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, NO.1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
- Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Hospital, 17 Hougou Lane, Chongwenmen, Beijing, 100005, China
| | - Ting Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, NO.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China
| | - Jianhong Chen
- Department of Gastroenterology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing Tongren Hospital, Capital Medical University, NO.1 Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
- Beijing Institute of Ophthalmology, Capital Medical University, Beijing Tongren Hospital, 17 Hougou Lane, Chongwenmen, Beijing, 100005, China.
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, NO.1 of Dongjiaominxiang Street, Dongcheng District, Beijing, 100730, China.
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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.
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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
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Garric C, Wamain Y, Rouland JF, Lenoble Q. Glaucoma-associated abnormalities in cortical activity during a visuocognitive task. Clin Neurophysiol 2023; 156:47-56. [PMID: 37866076 DOI: 10.1016/j.clinph.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/27/2023] [Accepted: 09/04/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE To investigate neurophysiological dynamics during a visuocognitive task in glaucoma patients vs. healthy controls. METHODS Fifteen patients with early-stage primary open-angle glaucoma (POAG) and fifteen age-matched healthy participants underwent a "go/no-go" task, monitored with EEG. Participants had to semantically categorize visual objects in central vision, with animal or furniture as targets according to the experimental block. RESULTS Early visual processing was delayed by 50 ms in patients with POAG compared to controls. The patients displayed a smaller difference between animal and furniture categorization during higher-level cognitive processing (at 400-600 ms). Regarding behavioral data, the groups differed in accuracy performance and decision criterion. As opposed to the control group, patients did not display facilitation and a higher accuracy rate for animal stimuli. However, patients maintained a consistent decision criterion throughout the experiment, whereas controls displayed a shift towards worse decision criteria in furniture trials, with higher error rate. CONCLUSIONS The comparative analysis of behavioral and neurophysiological data revealed in POAG patients a delay in early visual processing, and potential high-level cognitive compensation during late, task-dependent activations. SIGNIFICANCE To our knowledge, our findings provide the first evidence of modification in cognitive brain dynamics associated with POAG.
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Affiliation(s)
- Clémentine Garric
- Univ. Lille, INSERM, CHU Lille, U1172 - LilNCog - Lille Neuroscience and Cognition, F-59000 Lille, France.
| | - Yannick Wamain
- Univ. Lille, CNRS, CHU Lille, UMR 9193, SCALab, Sciences Cognitives et Sciences Affectives, F-59000 Lille, France.
| | - Jean-François Rouland
- Ophthalmology Department, Claude Huriez Hospital, University of Lille, F-59000 Lille, France.
| | - Quentin Lenoble
- Univ. Lille, INSERM, CHU Lille, U1172 - LilNCog - Lille Neuroscience and Cognition, F-59000 Lille, France.
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Martucci A, Di Giuliano F, Minosse S, Pocobelli G, Nucci C, Garaci F. MRI and Clinical Biomarkers Overlap between Glaucoma and Alzheimer's Disease. Int J Mol Sci 2023; 24:14932. [PMID: 37834380 PMCID: PMC10573932 DOI: 10.3390/ijms241914932] [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: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Glaucoma is the leading cause of blindness worldwide. It is classically associated with structural and functional changes in the optic nerve head and retinal nerve fiber layer, but the damage is not limited to the eye. The involvement of the central visual pathways and disruption of brain network organization have been reported using advanced neuroimaging techniques. The brain structural changes at the level of the areas implied in processing visual information could justify the discrepancy between signs and symptoms and underlie the analogy of this disease with neurodegenerative dementias, such as Alzheimer's disease, and with the complex group of pathologies commonly referred to as "disconnection syndromes." This review aims to summarize the current state of the art on the use of advanced neuroimaging techniques in glaucoma and Alzheimer's disease, highlighting the emerging biomarkers shared by both diseases.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; (S.M.); (F.G.)
| | - Giulio Pocobelli
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Francesco Garaci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; (S.M.); (F.G.)
- San Raffaele Cassino, 03043 Frosinone, Italy
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Issashar Leibovitzh G, Trope GE, Kherani IN, Buys YM, Tarita-Nistor L. Atypical responses to faces during binocular rivalry in early glaucoma. Front Neurosci 2023; 17:1151278. [PMID: 37304026 PMCID: PMC10248174 DOI: 10.3389/fnins.2023.1151278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/05/2023] [Indexed: 06/13/2023] Open
Abstract
Purpose Glaucoma is a progressive optic neuropathy that damages retinal ganglion cells and a neurodegenerative disease as it affects neural structures throughout the brain. In this study, we examined binocular rivalry responses in patients with early glaucoma in order to probe the function of stimulus-specific cortical areas involved in face perception. Methods Participants included 14 individuals (10 females, mean age 65 ± 7 years) with early pre-perimetric glaucoma and 14 age-matched healthy controls (7 females, mean age 59 ± 11 years). The 2 groups were equivalent in visual acuity and stereo-acuity. Three binocular rivalry stimulus pairs were used: (1) real face/house, (2) synthetic face/noise patch, and (3) synthetic face/spiral. For each stimulus pair, the images were matched in size and contrast level; they were viewed dichotically, and presented centrally and eccentrically at 3 degrees in the right (RH) and in the left hemifield (LH), respectively. The outcome measures were rivalry rate (i.e., perceptual switches/min) and time of exclusive dominance of each stimulus. Results For the face/house stimulus pair, rivalry rate of the glaucoma group (11 ± 6 switches/min) was significantly lower than that of the control group (15 ± 5 switches/min), but only in the LH location. The face dominated longer than the house in the LH for both groups. Likewise, for the synthetic face/noise patch stimulus pair, rivalry rate of the glaucoma group (11 ± 6 switches/min) was lower than that of the control group (16 ± 7 switches/min) in the LH, but the difference failed to reach significance. Interestingly, the mixed percept dominated less in glaucoma than in the control group. For the synthetic face/spiral stimulus pair, the glaucoma group had lower rivalry rate at all 3 stimulus locations. Conclusion This study reveals atypical responses to faces during binocular rivalry in patients with early glaucoma. The results may be suggestive of early neurodegeneration affecting stimulus-specific neural structures involved in face processing starting in the pre-perimetric phase of the disease.
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Affiliation(s)
- Galia Issashar Leibovitzh
- Krembil Research Institute, Donald K. Johnson Eye Institute, Toronto Western Hospital, Toronto, ON, Canada
| | - Graham E. Trope
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Irfan N. Kherani
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Yvonne M. Buys
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, ON, Canada
| | - Luminita Tarita-Nistor
- Krembil Research Institute, Donald K. Johnson Eye Institute, Toronto Western Hospital, Toronto, ON, Canada
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Liu P, Luo B, Chen L, Wang QX, Zhai LH, Wu HY, Zhao YL, Yuan G, Jiang GH, Zhang J. Preliminary Diffusion-Tensor Imaging Evidence for Trans-Synaptic Axonal Degeneration in Dysthyroid Optic Neuropathy Due to Thyroid-Associated Ophthalmopathy. J Magn Reson Imaging 2023; 57:834-844. [PMID: 35864716 DOI: 10.1002/jmri.28352] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 06/28/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The mechanism driving dysthyroid optic neuropathy (DON) is unclear. Diffusion-tensor imaging (DTI) allows for noninvasively assessing the microstructure of the entire visual pathway and may facilitate a better understanding of the mechanism of DON. PURPOSE To assess microstructural changes of the whole visual pathway and to investigate the potential mechanism of trans-synaptic damage(TSD) pathogenesis in DON with DTI. STUDY TYPE Cross-sectional. POPULATION Sixty-four patients with bilateral thyroid-associated ophthalmopathy (TAO), 30 with and 34 without DON, and 30 age- and sex-matched healthy controls (HCs). FIELD STRENGTH/SEQUENCE 3 T/DTI (A single-shot diffusion-weighted echo-planar imaging sequence). ASSESSMENT Differences in DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in each segment (optic nerve, tract, and radiation) of the entire visual pathway among the groups were compared. The parameters of visual evoked potentials (VEPs), visual field tests, and mean retinal nerve fiber layer (mRNFL) thickness on optical coherence tomography were also compared across patients. STATISTICAL TESTS Student's t-test, chi-square test; ANOVA with post-hoc testing, interclass correlation coefficient, and correlation analysis. Significance level: P < 0.05. RESULTS TAO patients with DON showed significantly reduced mRNFL thickness and abnormal VEPs. There was a tendency for gradually reduced FA and AD, and increased RD and MD from HCs, with non-DON to with DON in optic nerve and tract, statistically. For radiation, the RD and MD showed statistical increase, the AD and FA just showed numerical decrease (P = 0.119 and 0.059, respectively). For DON, the FA and MD of visual pathway segments showed correlations with abnormal VEPs. DATA CONCLUSION DTI may be a useful tool for detecting microstructural changes in the entire visual pathway in DON. The changes in RNFL thickness and DTI parameters suggested TSD as a potential pathogenic mechanism of DON. EVIDENCE LEVEL 4 Technical Efficacy: Stage 5.
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Affiliation(s)
- Ping Liu
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.,Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ban Luo
- Department of Ophthalmology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Lang Chen
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Qiu-Xia Wang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Lin-Han Zhai
- Department of Radiology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei, China
| | - Hong-Yu Wu
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Ya-Li Zhao
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gang Yuan
- Department of Endocrinology and Metabolism, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
| | - Gui-Hua Jiang
- Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - Jing Zhang
- Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, China
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Diffusion-weighted MR imaging and utility of ADC measurements in characterizing nerve and muscle changes in diabetic patients on ankle DWI studies: a cross-sectional study. Eur Radiol 2023:10.1007/s00330-023-09466-7. [PMID: 36806567 DOI: 10.1007/s00330-023-09466-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 11/17/2022] [Accepted: 01/22/2023] [Indexed: 02/21/2023]
Abstract
OBJECTIVE To evaluate the utility of apparent diffusion coefficient (ADC) measurements from ankle MRI diffusion-weighted imaging (DWI) studies in identifying neuropathic changes in diabetic patients. METHODS In total, 109 consecutive ankle MRI scans (n = 101 patients) at a single tertiary care county hospital from November 1, 2019, to July 11, 2021, who met the inclusion criteria were identified. Patients were divided into 2 cohorts: diabetic (n = 62) and non-diabetic (n = 39). Demographics, HgbA1c, neuropathy diagnosis, and image quality data were collected. Abductor hallucis (AH) ADC mean and minimum (min) values and posterior tibial nerve (PTN) ADC mean and minimum values were measured. Student t-test and Pearson's correlation coefficient analysis were performed using R. RESULTS Diabetic patients had significantly higher mean and min ADC values (× 10-3 mm2/s) of the AH muscle (mean: 1.77 vs 1.39, p < 0.001; min: 1.51 vs 1.06, p < 0.001) and PTN (mean: 1.65 vs 1.18, p < 0.001; min: 1.33 vs 0.95, p < 0.001) compared to non-diabetic patients. HgbA1c positively correlated with AH and PTN ADC mean values (AH: p = 0.036; PTN: p = 0.004). CONCLUSION Our data suggests that an increasing diffusivity of water as quantified by ADC across neuronal and muscular membranes is a consequence of the pathophysiology of the disease. Thus, ankle MRI-DWI studies are useful in identifying neuropathic changes in diabetic patients and quantifying the severity noninvasively. KEY POINTS • Diabetic patients had significantly higher mean and minimum ADC values of the abductor hallucis muscle and posterior tibial nerve compared to non-diabetic patients. • HgbA1c positively correlated with ADC mean values (AH: p = 0.036; PTN: p = 0.004) suggesting that an increasing diffusivity of water across neuronal and muscular membranes is a consequence of the pathophysiology of diabetic neuropathy. • Ankle MRI DWI can be used clinically to non-invasively identify neuropathic changes due to diabetes mellitus.
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Martucci A, Nucci C, Pinazo-Duran MD. Editorial: New perspectives in glaucoma pathophysiology, diagnosis, and treatment. Front Med (Lausanne) 2023; 10:1200427. [PMID: 37206469 PMCID: PMC10189111 DOI: 10.3389/fmed.2023.1200427] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 05/21/2023] Open
Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
- *Correspondence: Alessio Martucci
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
| | - Maria Dolores Pinazo-Duran
- Ophthalmic Research Unit “Santiago Grisolia”, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community, Valencia, Spain
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12
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Martucci A, Mancino R, Cesareo M, Pinazo-Duran MD, Nucci C. Combined use of coenzyme Q10 and citicoline: A new possibility for patients with glaucoma. Front Med (Lausanne) 2022; 9:1020993. [PMID: 36590976 PMCID: PMC9797721 DOI: 10.3389/fmed.2022.1020993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide. Several risk factors have been involved in the pathogenesis of the disease. By now, the main treatable risk factor is elevated intraocular pressure. Nevertheless, some patients, whose intraocular pressure is considered in the target level, still experience a progression of the disease. Glaucoma is a form of multifactorial ocular neurodegeneration with complex etiology, pathogenesis, and pathology. New evidence strongly suggests brain involvement in all aspects of this disease. This hypothesis and the need to prevent glaucomatous progression led to a growing interest in the pharmacological research of new neuroprotective, non-IOP-lowering, agents. The aim of this paper is to report evidence of the usefulness of Coenzyme Q10 and Citicoline, eventually combined, in the prevention of glaucomatous neurodegeneration.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy,*Correspondence: Alessio Martucci,
| | - Raffaele Mancino
- 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
| | - Maria Dolores Pinazo-Duran
- Ophthalmic Research Unit “Santiago Grisolia”, Foundation for the Promotion of Health and Biomedical Research of the Valencian Community (FISABIO), Valencia, Spain,Cellular and Molecular Ophthalmobiology Group, Department of Surgery, University of Valencia, Valencia, Spain
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, Rome, Italy
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13
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Wang Y, Chen L, Cai F, Gao J, Ouyang F, Chen Y, Yin M, Hua C, Zeng X. Altered functional connectivity of the thalamus in primary angle-closure glaucoma patients: A resting-state fMRI study. Front Neurol 2022; 13:1015758. [PMID: 36277918 PMCID: PMC9583913 DOI: 10.3389/fneur.2022.1015758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background and objectives Glaucoma is one of the leading irreversible causes of blindness worldwide, and previous studies have shown that there is abnormal functional connectivity (FC) in the visual cortex of glaucoma patients. The thalamus is a relay nucleus for visual signals; however, it is not yet clear how the FC of the thalamus is altered in glaucoma. This study investigated the alterations in thalamic FC in patients with primary angle-closure glaucoma (PACG) by using resting-state functional MRI (rs-fMRI). We hypothesized that PACG patients have abnormal FC between the thalamus and visual as well as extravisual brain regions. Methods Clinically confirmed PACG patients and age- and gender-matched healthy controls (HCs) were evaluated by T1 anatomical and functional MRI on a 3 T scanner. Thirty-four PACG patients and 33 HCs were included in the rs-fMRI analysis. All PACG patients underwent complete ophthalmological examinations; included retinal nerve fiber layer thickness (RNFLT), intraocular pressure (IOP), average cup-to-disc ratio (A-C/D), and vertical cup-to-disc ratio (V-C/D). After the MRI data were preprocessed, the bilateral thalamus was chosen as the seed point; and the differences in resting-state FC between groups were evaluated. The brain regions that significantly differed between PACG patients and HCs were identified, and the correlations were then evaluated between the FC coefficients of these regions and clinical variables. Results Compared with the HCs, the PACG patients showed decreased FC between the bilateral thalamus and right transverse temporal gyrus, between the bilateral thalamus and left anterior cingulate cortex, and between the left thalamus and left insula. Concurrently, increased FC was found between the bilateral thalamus and left superior frontal gyrus in PACG patients. The FC between the bilateral thalamus and left superior frontal gyrus was positively correlated with RNFLT and negatively correlated with the A-C/D and V-C/D. The FC between the left thalamus and left insula was negatively correlated with IOP. Conclusion Extensive abnormal resting-state functional connections between the thalamus and visual and extravisual brain areas were found in PACG patients, and there were certain correlations with clinical variables, suggesting that abnormal thalamic FC plays an important role in the progression of PACG.
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Affiliation(s)
- Yuanyuan Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linglong Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fengqin Cai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Junwei Gao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ouyang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ye Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mingxue Yin
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chengpeng Hua
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Xianjun Zeng
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Issashar Leibovitzh G, Trope GE, Buys YM, Tarita-Nistor L. Perceptual Grouping During Binocular Rivalry in Mild Glaucoma. Front Aging Neurosci 2022; 14:833150. [PMID: 35693345 PMCID: PMC9175031 DOI: 10.3389/fnagi.2022.833150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 04/25/2022] [Indexed: 11/14/2022] Open
Abstract
Purpose This study tested perceptual grouping during binocular rivalry to probe the strength of neural connectivity of the visual cortex involved in early visual processing in patients with mild glaucoma. Methods Seventeen patients with mild glaucoma with no significant visual field defects and 14 healthy controls participated. Rivalry stimuli were 1.8°-diameter discs, containing horizontal or vertical sine-wave gratings, viewed dichoptically. To test the grouping, two spatially separated identical stimuli were presented eccentrically to the same or different eyes and to the same or different hemifields. The outcome measures were the time of exclusive dominance of the grouped percept (i.e., percept with synchronized orientations), the rivalry rate, and the epochs of exclusive dominance. Results For both groups, the grouping occurred primarily for the matching orientations in the same eye/same hemifield (MO SE/SH) and for the matching orientations in the same eye/different hemifield (MO SE/DH) conditions. Time dominance of the grouped percept of the glaucoma group was similar to that of the control group in all conditions. The rivalry rates in the MO SE/SH and MO SE/DH conditions were significantly larger in the control group than in the glaucoma group. The epochs of exclusive dominance of the grouped percept in the MO SE/SH condition were a median of 48-ms longer for the control group, but a median of 116-ms shorter for the glaucoma group when compared to those in the MO SE/DH condition. Conclusion Patients with mild glaucoma show clear impairments in binocular rivalry while evidence for deficits in perceptual grouping could be inferred only indirectly. If these deficits truly exist, they may have implications for higher levels of visual processing, such as object recognition and scene segmentation, but these predictions remain to be tested in future studies.
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Affiliation(s)
- Galia Issashar Leibovitzh
- Krembil Research Institute, Donald K. Johnson Eye Institute, University Health Network, Toronto, ON, Canada
| | - Graham E. Trope
- Krembil Research Institute, Donald K. Johnson Eye Institute, University Health Network, Toronto, ON, Canada
- Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, ON, Canada
| | - Yvonne M. Buys
- Krembil Research Institute, Donald K. Johnson Eye Institute, University Health Network, Toronto, ON, Canada
- Department of Ophthalmology and Vision Sciences, Toronto Western Hospital, Toronto, ON, Canada
| | - Luminita Tarita-Nistor
- Krembil Research Institute, Donald K. Johnson Eye Institute, University Health Network, Toronto, ON, Canada
- *Correspondence: Luminita Tarita-Nistor,
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Mendoza M, Shotbolt M, Faiq MA, Parra C, Chan KC. Advanced Diffusion MRI of the Visual System in Glaucoma: From Experimental Animal Models to Humans. BIOLOGY 2022; 11:biology11030454. [PMID: 35336827 PMCID: PMC8945790 DOI: 10.3390/biology11030454] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022]
Abstract
Simple Summary This review summarizes current applications of advanced diffusion magnetic resonance imaging (MRI) throughout the glaucomatous visual system, focusing on the eye, optic nerve, optic tract, subcortical visual brain nuclei, optic radiations, and visual cortex. Glaucoma continues to be the leading cause of irreversible blindness worldwide and often remains undetected until later disease stages. The development of non-invasive methods for early detection of visual pathway integrity could pave the way for timely intervention and targeted treatment strategies. Principles of diffusion have been integrated with MRI protocols to produce a diffusion-weighted imaging modality for studying changes to tissue microstructures by quantifying the movement of water molecules in vivo. The development and applications of diffusion MRI in ophthalmology have allowed a better understanding of neural pathway changes in glaucoma. The feasibility of translating diffusion MRI techniques to assess both humans and experimental animal models of glaucoma and other optic neuropathies or neurodegenerative diseases is discussed. Recent research focuses on overcoming limitations in imaging quality, acquisition times, and biological interpretation suggest that diffusion MRI can provide an important tool for the non-invasive evaluation of glaucomatous changes in the visual system. Abstract Glaucoma is a group of ophthalmologic conditions characterized by progressive retinal ganglion cell death, optic nerve degeneration, and irreversible vision loss. While intraocular pressure is the only clinically modifiable risk factor, glaucoma may continue to progress at controlled intraocular pressure, indicating other major factors in contributing to the disease mechanisms. Recent studies demonstrated the feasibility of advanced diffusion magnetic resonance imaging (dMRI) in visualizing the microstructural integrity of the visual system, opening new possibilities for non-invasive characterization of glaucomatous brain changes for guiding earlier and targeted intervention besides intraocular pressure lowering. In this review, we discuss dMRI methods currently used in visual system investigations, focusing on the eye, optic nerve, optic tract, subcortical visual brain nuclei, optic radiations, and visual cortex. We evaluate how conventional diffusion tensor imaging, higher-order diffusion kurtosis imaging, and other extended dMRI techniques can assess the neuronal and glial integrity of the visual system in both humans and experimental animal models of glaucoma, among other optic neuropathies or neurodegenerative diseases. We also compare the pros and cons of these methods against other imaging modalities. A growing body of dMRI research indicates that this modality holds promise in characterizing early glaucomatous changes in the visual system, determining the disease severity, and identifying potential neurotherapeutic targets, offering more options to slow glaucoma progression and to reduce the prevalence of this world’s leading cause of irreversible but preventable blindness.
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Affiliation(s)
- Monica Mendoza
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
| | - Max Shotbolt
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
| | - Muneeb A. Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
| | - Carlos Parra
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
| | - Kevin C. Chan
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
- Department of Radiology, Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA
- Correspondence:
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16
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Kang L, Wan C. Application of advanced magnetic resonance imaging in glaucoma: a narrative review. Quant Imaging Med Surg 2022; 12:2106-2128. [PMID: 35284278 PMCID: PMC8899967 DOI: 10.21037/qims-21-790] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/26/2021] [Indexed: 04/02/2024]
Abstract
Glaucoma is a group of eye diseases characterized by progressive degeneration of the optic nerve head and retinal ganglion cells and corresponding visual field defects. In recent years, mounting evidence has shown that glaucoma-related damage may not be limited to the degeneration of retinal ganglion cells or the optic nerve head. The entire structure of the visual pathway may be degraded, and the degradation may even extend to some non-visual brain regions. We know that advanced morphological, functional, and metabolic magnetic resonance technologies provide a means to observe quantitatively and in real time the state of brain function. Advanced magnetic resonance imaging (MRI) techniques provide additional diagnostic markers for glaucoma, which are related to known potential histopathological changes. Many researchers in China and globally have conducted clinical and imaging studies on glaucoma. However, they are scattered, and we still need to systematically sort out the advanced MRI related to glaucoma. We reviewed literature published in any language and included all studies that were able to be translated into English from 1 January 1980 to 31 July 2021. Our literature search focused on emerging magnetic resonance neuroimaging techniques for the study of glaucoma. We then identified each functional area of the brain of glaucoma patients through the integration of anatomy, image, and function. The aim was to provide more information about the occurrence and development of glaucoma diseases. From the perspective of neuroimaging, our study provides a research basis to explain the possible mechanism of the occurrence and development of glaucoma. This knowledge gained from these techniques enables us to more clearly observe the damage glaucoma causes to the whole visual pathway. Our study provides new insights into glaucoma-induced changes to the brain. Our findings may enable the progress of these changes to be analyzed and inspire new neuroprotective therapeutic strategies for patients with glaucoma in the future.
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Affiliation(s)
- Longdan Kang
- Department of Ophthalmology, the First Hospital of China Medical University, Shenyang, China
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Xue J, Zhu Y, Liu Z, Lin J, Li Y, Li Y, Zhuo Y. Demyelination of the Optic Nerve: An Underlying Factor in Glaucoma? Front Aging Neurosci 2021; 13:701322. [PMID: 34795572 PMCID: PMC8593209 DOI: 10.3389/fnagi.2021.701322] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Neurodegenerative disorders are characterized by typical neuronal degeneration and axonal loss in the central nervous system (CNS). Demyelination occurs when myelin or oligodendrocytes experience damage. Pathological changes in demyelination contribute to neurodegenerative diseases and worsen clinical symptoms during disease progression. Glaucoma is a neurodegenerative disease characterized by progressive degeneration of retinal ganglion cells (RGCs) and the optic nerve. Since it is not yet well understood, we hypothesized that demyelination could play a significant role in glaucoma. Therefore, this study started with the morphological and functional manifestations of demyelination in the CNS. Then, we discussed the main mechanisms of demyelination in terms of oxidative stress, mitochondrial damage, and immuno-inflammatory responses. Finally, we summarized the existing research on the relationship between optic nerve demyelination and glaucoma, aiming to inspire effective treatment plans for glaucoma in the future.
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Affiliation(s)
- Jingfei Xue
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yingting Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Zhe Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Jicheng Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yangjiani Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yiqing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yehong Zhuo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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18
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Colbert MK, Ho LC, van der Merwe Y, Yang X, McLellan GJ, Hurley SA, Field AS, Yun H, Du Y, Conner IP, Parra C, Faiq MA, Fingert JH, Wollstein G, Schuman JS, Chan KC. Diffusion Tensor Imaging of Visual Pathway Abnormalities in Five Glaucoma Animal Models. Invest Ophthalmol Vis Sci 2021; 62:21. [PMID: 34410298 PMCID: PMC8383913 DOI: 10.1167/iovs.62.10.21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose To characterize the visual pathway integrity of five glaucoma animal models using diffusion tensor imaging (DTI). Methods Two experimentally induced and three genetically determined models of glaucoma were evaluated. For inducible models, chronic IOP elevation was achieved via intracameral injection of microbeads or laser photocoagulation of the trabecular meshwork in adult rodent eyes. For genetic models, the DBA/2J mouse model of pigmentary glaucoma, the LTBP2 mutant feline model of congenital glaucoma, and the transgenic TBK1 mouse model of normotensive glaucoma were compared with their respective genetically matched healthy controls. DTI parameters, including fractional anisotropy, axial diffusivity, and radial diffusivity, were evaluated along the optic nerve and optic tract. Results Significantly elevated IOP relative to controls was observed in each animal model except for the transgenic TBK1 mice. Significantly lower fractional anisotropy and higher radial diffusivity were observed along the visual pathways of the microbead- and laser-induced rodent models, the DBA/2J mice, and the LTBP2-mutant cats compared with their respective healthy controls. The DBA/2J mice also exhibited lower axial diffusivity, which was not observed in the other models examined. No apparent DTI change was observed in the transgenic TBK1 mice compared with controls. Conclusions Chronic IOP elevation was accompanied by decreased fractional anisotropy and increased radial diffusivity along the optic nerve or optic tract, suggestive of disrupted microstructural integrity in both inducible and genetic glaucoma animal models. The effects on axial diffusivity differed between models, indicating that this DTI metric may represent different aspects of pathological changes over time and with severity.
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Affiliation(s)
- Max K Colbert
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - Leon C Ho
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Yolandi van der Merwe
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Xiaoling Yang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Gillian J McLellan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin - Madison, Madison, Wisconsin, United States.,McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, Wisconsin, United States
| | - Samuel A Hurley
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, United States
| | - Aaron S Field
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, United States
| | - Hongmin Yun
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Yiqin Du
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Ian P Conner
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carlos Parra
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - Muneeb A Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - John H Fingert
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States
| | - Joel S Schuman
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States.,Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - Kevin C Chan
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States.,Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
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19
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Wu Q, Hu H, Chen W, Chen HH, Chen L, Zhou J, Liu H, Wu FY, Xu XQ. Disrupted Topological Organization of the Brain Structural Network in Patients With Thyroid-Associated Ophthalmopathy. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 33821882 PMCID: PMC8039468 DOI: 10.1167/iovs.62.4.5] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Increasing evidence indicated that thyroid-associated ophthalmopathy (TAO) might be a neural related disease more than an ocular disease. In this study, we aimed to investigate the alterations of structural brain connectome in patients with TAO. Methods Twenty-seven patients with TAO and 27 well-matched healthy controls underwent diffusion tensor imaging. Graph theoretical analyses, including global (shortest path length, clustering coefficient, small-worldness, global efficiency, and local efficiency) and nodal (nodal betweenness, nodal degree, and nodal efficiency) topological properties and network-based statistics were performed to evaluate TAO-related changes in brain network pattern. Correlations were assessed between the network properties and clinical variables, including disease duration, visual acuity, neuropsychiatric measurements, and serum thyroid function indexes. Results Compared with healthy controls, patients with TAO exhibited preserved global network parameters but altered nodal properties. We found decreased nodal betweenness and nodal degree in right anterior cingulate and paracingulate gyri, decreased nodal degree and nodal efficiency in the right orbital part of middle frontal gyrus (ORBmid), whereas increased nodal degree and nodal efficiency in the left cuneus. Decrease of structural connectivity strength was found involving the right ORBmid, right putamen, left caudate nucleus, and left medial superior frontal gyrus. Significant correlations were also found between nodal properties and neuropsychological performances as well as visual acuity. Conclusions Patients with TAO developed disruption of structural brain network connectome. Disrupted topological organization of the brain structural network may be associated with the clinical-psychiatric dysfunction of patients with TAO.
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Affiliation(s)
- Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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