与症状性集合不足相关的潜在神经机制。
Underlying neurological mechanisms associated with symptomatic convergence insufficiency.
机构信息
Biomedical Engineering, New Jersey Institute of Technology, Newark, NJ, USA.
Pennsylvania College of Optometry, Salus University, Philadelphia, PA, USA.
出版信息
Sci Rep. 2021 Mar 22;11(1):6545. doi: 10.1038/s41598-021-86171-9.
Convergence insufficiency (CI) is the most common binocular vision problem, associated with blurred/double vision, headaches, and sore eyes that are exacerbated when doing prolonged near work, such as reading. The Convergence Insufficiency Neuro-mechanism Adult Population Study (NCT03593031) investigates the mechanistic neural differences between 50 binocularly normal controls (BNC) and 50 symptomatic CI participants by examining the fast and slow fusional disparity vergence systems. The fast fusional system is preprogrammed and is assessed with convergence peak velocity. The slow fusional system optimizes vergence effort and is assessed by measuring the phoria adaptation magnitude and rate. For the fast fusional system, significant differences are observed between the BNC and CI groups for convergence peak velocity, final position amplitude, and functional imaging activity within the secondary visual cortex, right cuneus, and oculomotor vermis. For the slow fusional system, the phoria adaptation magnitude and rate, and the medial cuneus functional activity, are significantly different between the groups. Significant correlations are observed between vergence peak velocity and right cuneus functional activity (p = 0.002) and the rate of phoria adaptation and medial cuneus functional activity (p = 0.02). These results map the brain-behavior of vergence. Future therapeutic interventions may consider implementing procedures that increase cuneus activity for this debilitating disorder.
集合不足(CI)是最常见的双眼视觉问题,与模糊/复视、头痛和眼睛酸痛有关,在进行长时间的近距离工作(如阅读)时会加重。《集合不足神经机制成人研究》(NCT03593031)通过检查快速和慢速融合性视差聚散系统,研究了 50 名双眼正常对照者(BNC)和 50 名有症状 CI 参与者之间的神经机制差异。快速融合系统是预编程的,通过会聚峰速度来评估。慢速融合系统通过测量斜视适应幅度和速率来优化聚散努力。对于快速融合系统,在会聚峰速度、最终位置幅度以及二级视觉皮层、右侧楔叶和动眼神经小脑的功能成像活性方面,BNC 和 CI 组之间存在显著差异。对于慢速融合系统,斜视适应幅度和速率以及内侧楔叶的功能活动在组间存在显著差异。会聚峰速度与右侧楔叶功能活动之间存在显著相关性(p=0.002),以及斜视适应速率与内侧楔叶功能活动之间存在显著相关性(p=0.02)。这些结果描绘了聚散的大脑-行为。未来的治疗干预可能需要考虑增加楔叶活动的程序,以治疗这种使人衰弱的疾病。