Guo Jianlin, Chen Yuanyuan, Liu Wen, Huang Lijuan, Hu Di, Lv Yanqiu, Kang Huiying, Li Ningdong, Peng Yun
Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Tianjin International Joint Research Center for Neural Engineering, Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China.
Front Neurosci. 2022 Aug 18;16:972882. doi: 10.3389/fnins.2022.972882. eCollection 2022.
Previous studies have shown that functional networks are present at birth and change dynamically throughout infancy and early childhood. However, the status of functional connectivity is still poorly understood in patients with infantile esotropia (IE). The aim of this study is to investigate the developmental trends of functional connectivity in patients with IE during a critical period of growth and development. A total of 17 patients with IE (9 males and 8 females; mean age: 3.36 ± 2.03 years, age range: 0.67-6.36 years) and 20 healthy subjects matched for age and gender were recruited and underwent resting-state functional magnetic resonance imaging. The whole-brain functional network connectivity was analyzed for the IE group and healthy control group. A general linear model was applied to assess the group-age interaction in terms of the functional connectivity. The discrepancy between the two groups in functional connectivity trajectories was also quantified across age and exhibited by the quadratic parabolic model. There were significant group-age interactions between the visual network and the default mode network, the visual network and the sensorimotor network, the limbic network and the default mode network, and within the limbic network in the functional connectivity. A U-shaped tendency across age, with an "inflection point" ranging from 3.1 to 4.0 years of age was exhibited in the difference between functional connectivity trajectories of the IE patients and normal controls. Abnormality in functional network connectivity could present in IE patients at birth, exhibiting aberrant developmental patterns over time. An abnormal functional network could reduce the ability of the cortex in visual information processing, further reactivating the subcortical visual information processing system, which is probably the pathogenesis of IE. Three to four years after birth is the critical time window for children with IE to establish normal network connections in the brain. Early surgery during this period may be helpful for affected children to have an opportunity to approach the normal development trajectory as early as possible.
先前的研究表明，功能网络在出生时就已存在，并在婴儿期和幼儿期动态变化。然而，婴儿型内斜视（IE）患者的功能连接状态仍知之甚少。本研究的目的是调查IE患者在生长发育关键期的功能连接发育趋势。共招募了17例IE患者（9例男性，8例女性；平均年龄：3.36±2.03岁，年龄范围：0.67 - 6.36岁）和20名年龄及性别匹配的健康受试者，并对他们进行静息态功能磁共振成像检查。对IE组和健康对照组进行全脑功能网络连接分析。应用一般线性模型评估功能连接方面的组-年龄交互作用。还对两组在功能连接轨迹上的差异进行了年龄跨度的量化，并通过二次抛物线模型展示。在功能连接方面，视觉网络与默认模式网络、视觉网络与感觉运动网络、边缘系统网络与默认模式网络之间以及边缘系统网络内部存在显著的组-年龄交互作用。IE患者与正常对照组功能连接轨迹差异在年龄上呈现出U形趋势，“拐点”在3.1至4.0岁之间。IE患者出生时可能就存在功能网络连接异常，并随着时间呈现异常发育模式。异常的功能网络可能会降低皮质处理视觉信息的能力，进而重新激活皮质下视觉信息处理系统，这可能是IE的发病机制。出生后三到四年是IE患儿在大脑中建立正常网络连接的关键时间窗口。在此期间尽早手术可能有助于患病儿童有机会尽早接近正常发育轨迹。
