Department of Medical Imaging, Guangdong Second Provincial General Hospital, Guangzhou, China.
Department of Radiology, The Affiliated Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, #1095 Jiefang Road, Wuhan, 430030, Hubei, People's Republic of China.
Eur Radiol. 2023 Nov;33(11):7981-7991. doi: 10.1007/s00330-023-09829-0. Epub 2023 Jul 6.
To investigate the brain functional alterations in dysthyroid optic neuropathy (DON) by evaluating spontaneous neural activity, using functional magnetic resonance imaging (fMRI) with regional homogeneity (ReHo), and its relationship with ophthalmologic performance.
Forty-seven patients with thyroid-associated ophthalmopathy (TAO; 20 with DON, 27 with non-DON) and 33 age-, sex-, and education-matched healthy controls (HCs) underwent fMRI. ReHo values were compared using one-way analysis of variance (ANOVA) with post hoc pairwise comparisons (voxel-level p < 0.01, Gaussian random field correction, cluster-level p < 0.05). Correlations between ReHo values and ophthalmological metrics were assessed for DONs, with Bonferroni correction for multiple comparisons (p < 0.004). ROC curves were applied to evaluate the diagnostic performance of ReHo metrics.
ReHo values were significantly lower in the left insula and right superior temporal gyrus, and higher in the left posterior cingulate cortex (LPCC), of DON than of non-DON patients. ReHo values were also significantly lower in the right middle temporal, left insula, and left precentral gyrus in DON than in HCs. Meanwhile, ReHo values were higher in LPCC in non-DON than in HCs. ReHo values correlated with ophthalmic examinations to varying degrees in DON. For distinguishing DON, the ReHo values in LPCC showed optimal individually (AUC = 0.843), the combination of the ReHo in both the left insula and LPCC performed better (AUC = 0.915).
Spontaneous brain activity differed between TAO with and without DON, which may reflect the underlying pathological mechanism of DON. The ReHo index can be considered a diagnostic biomarker.
Spontaneous brain activity in DON differed from that in TAO without DON, which may reflect the underlying pathological mechanism of DON. The ReHo index can be considered a diagnostic biomarker for early detection of DON.
• Dysthyroid optic neuropathy (DON) affects brain activity, which contributes in the understanding of its visual dysfunction. • Regional homogeneity values differ between thyroid-associated ophthalmopathy with and without DON in various brain regions. • Regional homogeneity values can be used as a biomarker in the differential diagnosis of DON.
通过评估功能磁共振成像（fMRI）局部一致性（ReHo）的自发性神经活动，研究甲状腺相关眼病（TAO）伴和不伴甲状腺相关眼病性视神经病变（DON）的脑功能改变，并探讨其与眼科表现的关系。
对 47 例甲状腺相关眼病患者（20 例 DON，27 例非 DON）和 33 名年龄、性别和教育程度相匹配的健康对照者（HCs）进行 fMRI 检查。采用单因素方差分析（ANOVA）比较 ReHo 值，并进行事后两两比较（体素水平 p<0.01，高斯随机场校正，簇水平 p<0.05）。对 DON 患者进行 ReHo 值与眼科指标的相关性分析，并进行多次比较的 Bonferroni 校正（p<0.004）。采用 ROC 曲线评估 ReHo 指标的诊断性能。
与非 DON 患者相比，DON 患者的左侧岛叶和右侧颞上回的 ReHo 值显著降低，而左侧后扣带回皮质（LPCC）的 ReHo 值显著升高。与 HCs 相比，DON 患者的右侧颞中回、左侧岛叶和左侧中央前回的 ReHo 值也显著降低。同时，非 DON 患者的 LPCC 的 ReHo 值高于 HCs。DON 患者的 ReHo 值与眼科检查呈不同程度的相关性。对于区分 DON，LPCC 的 ReHo 值表现最佳（AUC=0.843），左侧岛叶和 LPCC 的 ReHo 值联合应用效果更好（AUC=0.915）。
TAO 伴和不伴 DON 的自发脑活动不同，这可能反映了 DON 的潜在病理机制。ReHo 指数可作为 DON 的诊断生物标志物。
DON 患者的脑活动与 TAO 无 DON 患者不同，这可能反映了 DON 的潜在病理机制。ReHo 指数可作为 DON 的早期检测诊断生物标志物。
• DON 影响大脑活动，这有助于理解其视觉功能障碍。• 甲状腺相关眼病伴和不伴 DON 的局部一致性值在不同脑区存在差异。• 局部一致性值可作为 DON 鉴别诊断的生物标志物。
