Altered voxel-wise degree centrality associated with patients with comitant exotropia.

Objective of the study is to investigate the altered intrinsic functional hubs in patients with comitant exotropia (CE) using the voxel-wise degree centrality (DC) analysis method. A total of 28 CE patients and 28 healthy controls (HCs) similarly matched in sex, age, and education level were recruited in this study. All subjects underwent a resting-state functional MRI scan, the voxel-wise DC method was applied to evaluate brain network hubs alterations in CE patients. Then, the DC maps between two groups were chosen to be classification features to distinguish patients with CE from HCs based on the support vector machine (SVM) model. The algorithm performance was evaluated by a permutation test. Compared with HCs, CE patients exhibited significant enhanced DC value in the left cerebelum 8 and the right cerebelum 3; and remarkably decreased DC value in the right precentral gyrus, right anterior cingulated, and paracingulate gyri (two-tailed, voxel level: P < 0.01; GRF correction, cluster level: P < 0.05). However, no relationship was found between the observed average DC of the different brain regions and the clinical features ( P > 0.05). In addition, the SVM model showed an accuracy of 83.93% to clarify CE patients from HCs using the DC maps as a classification feature. CE patients displayed altered functional network hubs in multiple brain areas associated with cognition and motor control, and the DC variability could classify patients from HCs with high accuracy. These findings may assist to understand the neuropathological mechanism for the disease.