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原发性开角型青光眼患者功能和解剖性大脑半球间同型连接减少:一项静息态 fMRI 和 DTI 的联合研究。

Reduced Functional and Anatomic Interhemispheric Homotopic Connectivity in Primary Open-Angle Glaucoma: A Combined Resting State-fMRI and DTI Study.

机构信息

Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing, China.

出版信息

Invest Ophthalmol Vis Sci. 2018 Apr 1;59(5):1861-1868. doi: 10.1167/iovs.17-23291.

Abstract

PURPOSE

To investigate if abnormal interhemispheric homotopic functional connectivity were accompanied by corresponding anatomic connectivity changes in primary open-angle glaucoma (POAG) patients, and to relate connectivity changes with retinal nerve fiber layer (RNFL) thickness and ganglion cell complex (GCC) thickness.

METHODS

Resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) were performed in 16 POAG patients and 19 healthy controls. Indices of interhemispheric homotopic functional connectivity and the underlying anatomic connectivity changes were derived with voxel-base whole-brain voxel-mirrored homotopic connectivity (VMHC) analyses and VMHC-guided probabilistic tractography. Pearson correlation analyses were used to explore the correlations between interhemispheric homotopic functional connectivity changes and anatomic connectivity alterations, and RNFL and GCC thickness.

RESULTS

Reduced VMHC values between bilateral homotopic cortical areas located in Brodmann area (BA)17, BA18, and BA19. Decreased anatomic connectivity connecting bilateral visual cortical areas inside BA17 and BA18 were observed in POAG patients. Furthermore, positive correlations between average RNFL thickness and reduced VMHC values of BA17 (r = 0.572, P = 0.021)/BA18 (r = 0.600, P = 0.014)/BA19 (r = 0.550, P = 0.027) are found using Pearson correlation analyses.

CONCLUSIONS

Combinations of interhemispheric homotopic functional connectivity and anatomic connectivity changes may help to elucidate the mechanism of interhemispheric synchronization injury in POAG patients. Reduced VMHC values positively correlate with glaucomatous changes of RNFL thickness, which strengthens the hypothesis that POAG affects the visual cortex using a novel functional MRI characteristic.

摘要

目的

研究原发性开角型青光眼(POAG)患者是否存在半球间同源功能连接的异常,并与视网膜神经纤维层(RNFL)厚度和节细胞复合体(GCC)厚度相关。

方法

对 16 例 POAG 患者和 19 例健康对照者进行静息态功能磁共振成像(rs-fMRI)和弥散张量成像(DTI)检查。采用基于体素的全脑体素镜像同伦连接(VMHC)分析和 VMHC 引导的概率追踪技术,得出半球间同源功能连接的指标及其潜在的解剖连接变化。采用 Pearson 相关分析,探讨半球间同源功能连接变化与解剖连接改变以及 RNFL 和 GCC 厚度之间的相关性。

结果

双侧同源皮质区(位于 Brodmann 区 17、18 和 19 区)之间的 VMHC 值降低。POAG 患者双侧视觉皮质区内部 BA17 和 BA18 的解剖连接减少。此外,平均 RNFL 厚度与 BA17(r=0.572,P=0.021)/BA18(r=0.600,P=0.014)/BA19(r=0.550,P=0.027)VMHC 值降低呈正相关,Pearson 相关分析结果提示。

结论

半球间同源功能连接和解剖连接变化的组合可能有助于阐明 POAG 患者半球间同步损伤的机制。VMHC 值降低与 RNFL 厚度的青光眼变化呈正相关,这进一步支持了 POAG 通过一种新的功能 MRI 特征影响视皮层的假说。

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