Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Hum Brain Mapp. 2023 Nov;44(16):5346-5356. doi: 10.1002/hbm.26437. Epub 2023 Jul 29.
Although previous neuroimaging evidence has confirmed the brain functional disturbances in thyroid-associated ophthalmopathy (TAO), the dynamic characteristics of brain activity and functional connectivity (FC) in TAO were rarely concerned. The present study aims to investigate the alterations of temporal variability of brain activity and FC in TAO using resting-state functional magnetic resonance imaging (rs-fMRI). Forty-seven TAO patients and 30 age-, gender-, education-, and handedness-matched healthy controls (HCs) were enrolled and underwent rs-fMRI scanning. The dynamic amplitude of low-frequency fluctuation (dALFF) was first calculated using a sliding window approach to characterize the temporal variability of brain activity. Based on the dALFF results, seed-based dynamic functional connectivity (dFC) analysis was performed to identify the temporal variability of efficient communication between brain regions in TAO. Additionally, correlations between dALFF and dFC and the clinical indicators were analyzed. Compared with HCs, TAO patients displayed decreased dALFF in the left superior occipital gyrus (SOG) and cuneus (CUN), while showing increased dALFF in the left triangular part of inferior frontal gyrus (IFGtriang), insula (INS), orbital part of inferior frontal gyrus (ORBinf), superior temporal gyrus (STG) and temporal pole of superior temporal gyrus (TPOsup). Furthermore, TAO patients exhibited decreased dFC between the left STG and the right middle occipital gyrus (MOG), as well as decreased dFC between the left TPOsup and the right calcarine fissure and surrounding cortex (CAL) and MOG. Correlation analyses showed that the altered dALFF in the left SOG/CUN was positively related to visual acuity (r = .409, p = .004), as well as the score of QoL for visual functioning (r = .375, p = .009). TAO patients developed abnormal temporal variability of brain activity in areas related to vision, emotion, and cognition, as well as reduced temporal variability of FC associated with vision deficits. These findings provided additional insights into the neurobiological mechanisms of TAO.
尽管先前的神经影像学证据已经证实了甲状腺相关眼病（TAO）患者的大脑功能紊乱，但很少关注 TAO 患者大脑活动和功能连接（FC）的动态特征。本研究旨在使用静息态功能磁共振成像（rs-fMRI）来探讨 TAO 患者大脑活动和 FC 的时间变异性的改变。招募了 47 名 TAO 患者和 30 名年龄、性别、教育程度和利手相匹配的健康对照者（HCs），并进行了 rs-fMRI 扫描。首先使用滑动窗口方法计算低频波动的动态幅度（dALFF），以表征大脑活动的时间变异性。基于 dALFF 结果，进行种子点动态功能连接（dFC）分析，以识别 TAO 患者大脑区域之间有效通讯的时间变异性。此外，还分析了 dALFF 和 dFC 与临床指标之间的相关性。与 HCs 相比，TAO 患者左顶下额回（SOG）和楔前叶（CUN）的 dALFF 降低，左额下回三角部（IFGtriang）、岛叶（INS）、眶部额下回（ORBinf）、颞上回（STG）和颞上回颞极（TPOsup）的 dALFF 升高。此外，TAO 患者左 STG 与右侧中枕叶（MOG）之间的 dFC 降低，左 TPOsup 与右侧距状裂及其周围皮层（CAL）和 MOG 之间的 dFC 降低。相关分析显示，左 SOG/CUN 的改变的 dALFF 与视力（r = .409，p = .004）以及视觉功能生活质量评分（r = .375，p = .009）呈正相关。TAO 患者的大脑活动在与视觉、情绪和认知相关的区域出现异常的时间变异性，以及与视觉缺陷相关的 FC 的时间变异性降低。这些发现为 TAO 的神经生物学机制提供了新的见解。
