Wenzhou Medical University, Wenzhou, China.
Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Endocrinol (Lausanne). 2022 Jul 22;13:895186. doi: 10.3389/fendo.2022.895186. eCollection 2022.
To investigate changes in local spontaneous brain activity in patients with active thyroid-associated ophthalmopathy (TAO) and explore the relationship between such alterations and microvascular indices.
Thirty-six active TAO patients with active phase and 39 healthy controls (HCs) were enrolled in this study. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI), neuropsychological tests, and ophthalmological examinations. The rs-fMRI-based fractional low-frequency fluctuation amplitude (fALFF) analysis methods were used to assess spontaneous brain activity in both groups. The structure (peripapillary retinal nerve fiber layer, pRNFL) and microvascular indices (the optic nerve head (ONH) whole image vessel density, ONH-wiVD, and peripapillary vessel density) were analyzed through optical coherence tomographic angiography imaging. The relationship between abnormal spontaneous brain activity and ophthalmological indices was analyzed using the Spearman's rank correlation analysis.
Compared with HCs, active TAO patients had increased fALFF in the right inferior temporal gyrus (R.ITG) and left posterior cingulate gyrus (L.PCC), but decreased fALFF in the right calcarine (R.CAL). The fALFF values in L.PCC were positively correlated with peripapillary vessel density, whereas fALFF values in R.CAL were negatively related to peripapillary vessel density.
This study demonstrates that changes in spontaneous brain activity of active TAO are accompanied by peripapillary microvascular variations. These results provide insights into the pathophysiological mechanisms of active TAO. In addition, the combination of fALFF values and peripapillary vessel density may be served as important references for better clinical decision making.
探讨活动期甲状腺相关眼病（TAO）患者局部自发性脑活动的变化，并探讨这些变化与微血管指数之间的关系。
本研究纳入了 36 例活动期 TAO 患者（活动期）和 39 名健康对照者（HCs）。所有参与者均接受了静息态功能磁共振成像（rs-fMRI）、神经心理学测试和眼科检查。使用 rs-fMRI 基于分数低频波动幅度（fALFF）分析方法评估两组的自发性脑活动。通过光学相干断层扫描血管造影成像分析结构（视盘周围视网膜神经纤维层，pRNFL）和微血管指数（视神经头（ONH）全像血管密度，ONH-wiVD 和视盘周围血管密度）。采用 Spearman 秩相关分析方法分析异常自发性脑活动与眼科指标之间的关系。
与 HCs 相比，活动期 TAO 患者右颞下回（R.ITG）和左后扣带回（L.PCC）的 fALFF 增加，而右距状裂（R.CAL）的 fALFF 降低。L.PCC 的 fALFF 值与视盘周围血管密度呈正相关，而 R.CAL 的 fALFF 值与视盘周围血管密度呈负相关。
本研究表明，活动期 TAO 患者自发性脑活动的变化伴随着视盘周围微血管的变化。这些结果为活动期 TAO 的病理生理机制提供了新的见解。此外，fALFF 值和视盘周围血管密度的结合可能为更好的临床决策提供重要参考。
