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功能磁共振成像显示高眼压对高血压性青光眼患者中枢神经系统的影响。

Functional MRI reveals effects of high intraocular pressure on central nervous system in high-tension glaucoma patients.

机构信息

Department of Ophthalmology, Affiliated Hospital of Taishan Medical University, Taian, China.

Department of Ophthalmology, Taishan Medical University, Taian, China.

出版信息

Acta Ophthalmol. 2019 May;97(3):e341-e348. doi: 10.1111/aos.14027. Epub 2019 Feb 22.

Abstract

PURPOSE

To evaluate the effects of high intraocular pressure (IOP) on central nervous system in patients with high-tension glaucoma (HTG) by using resting-state functional magnetic resonance imaging (rs-fMRI).

METHODS

Thirty-six patients with HTG and twenty age- and gender-matched healthy controls (HCs) were recruited and underwent IOP measurement and rs-fMRI scan. The whole brain regional homogeneity (ReHo) value was calculated among the enrolled subjects. Two-sample t tests with permutation test and threshold-free cluster enhancement was performed between HTG group and HCs. Correlation analyses between IOP and ReHo values were conducted.

RESULTS

Compared with HCs, HTG group showed increased ReHo values in the left lobule 8 of cerebellar hemisphere, left lobule 4 and 5 of cerebellar hemisphere and left fusiform gyrus (FG) (p < 0.05). HTG group showed decreased ReHo value in the left middle frontal gyrus (MFG) (p < 0.05). Intraocular pressure of the left eye in HTG group experienced a significant positive correlation with ReHo value of the left FG (r = 0.370, p = 0.026), IOP of the right eye in HTG group showed a significant negative correlation with ReHo value in the left MFG (r = -0.421, p = 0.011).

CONCLUSION

Resting-state fMRI ReHo analyses associated elevated IOP with abnormal regional activity in several brain regions related to higher visual function and visual memory consolidation. High-tension glaucoma patients also showed diminished integration of visual information and cerebellar function. These results may provide imaging support for pathophysiological research of HTG and may reveal new targets for the accurate treatment of HTG.

摘要

目的

利用静息态功能磁共振成像(rs-fMRI)评估高眼压(IO P)对高血压性青光眼(HTG)患者中枢神经系统的影响。

方法

招募了 36 名 HTG 患者和 20 名年龄和性别匹配的健康对照者(HCs),并进行了 IOP 测量和 rs-fMRI 扫描。在纳入的受试者中计算全脑区域同质性(ReHo)值。采用两样本 t 检验(采用置换检验和阈值自由聚类增强),比较 HTG 组和 HCs 之间的差异。对 IOP 与 ReHo 值之间的相关性进行了分析。

结果

与 HCs 相比,HTG 组左侧小脑半球第 8 小叶、左侧小脑半球第 4、5 小叶和左侧梭状回(梭状回)的 ReHo 值增加(p<0.05)。HTG 组左侧额中回(额中回)的 ReHo 值降低(p<0.05)。HTG 组左眼眼压与左侧 FG 的 ReHo 值呈显著正相关(r=0.370,p=0.026),右眼眼压与左侧 MFG 的 ReHo 值呈显著负相关(r=-0.421,p=0.011)。

结论

静息态 fMRI ReHo 分析表明,升高的眼压与几个与较高视觉功能和视觉记忆巩固相关的脑区的异常区域活动有关。HTG 患者还表现出视觉信息整合和小脑功能减退。这些结果可能为 HTG 的病理生理学研究提供影像学支持,并可能为 HTG 的准确治疗揭示新的靶点。

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