Department of Radiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, 330006, Jiangxi, China.
Queen Mary School, Jiangxi Medical College, Nanchang University, Nanchang, 330006, Jiangxi, China.
Brain Topogr. 2024 Nov;37(6):1171-1185. doi: 10.1007/s10548-024-01060-4. Epub 2024 Jun 1.
Primary angle-closure glaucoma (PACG) is a sight-threatening eye condition that leads to irreversible blindness. While past neuroimaging research has identified abnormal brain function in PACG patients, the relationship between PACG and alterations in brain functional networks has yet to be explored. This study seeks to examine the influence of PACG on brain networks, aiming to advance knowledge of its neurobiological processes for better diagnostic and therapeutic approaches utilizing graph theory analysis. A cohort of 44 primary angle-closure glaucoma (PACG) patients and 44 healthy controls participated in this study. Functional brain networks were constructed using fMRI data and the Automated Anatomical Labeling 90 template. Subsequently, graph theory analysis was employed to evaluate global metrics, nodal metrics, modular organization, and network-based statistics (NBS), enabling a comparative analysis between PACG patients and the control group. The analysis of global metrics, including small-worldness and network efficiency, did not exhibit significant differences between the two groups. However, PACG patients displayed elevated nodal metrics, such as centrality and efficiency, in the left frontal superior medial, right frontal superior medial, and right posterior central brain regions, along with reduced values in the right temporal superior gyrus region compared to healthy controls. Furthermore, Module 5 showed notable disparities in intra-module connectivity, while Module 1 demonstrated substantial differences in inter-module connectivity with both Module 7 and Module 8. Noteworthy, the NBS analysis unveiled a significantly altered network when comparing the PACG and healthy control groups. The study proposes that PACG patients demonstrate variations in nodal metrics and modularity within functional brain networks, particularly affecting the prefrontal, occipital, and temporal lobes, along with cerebellar regions. However, an analysis of global metrics suggests that the overall connectivity patterns of the entire brain network remain unaltered in PACG patients. These results have the potential to serve as early diagnostic and differential markers for PACG, and interventions focusing on brain regions with high degree centrality and nodal efficiency could aid in optimizing therapeutic approaches.
原发性闭角型青光眼（PACG）是一种致盲性眼病，可导致不可逆转的失明。虽然过去的神经影像学研究已经确定了 PACG 患者大脑功能异常，但 PACG 与大脑功能网络改变之间的关系尚未得到探索。本研究旨在利用图论分析研究 PACG 对大脑网络的影响，旨在深入了解其神经生物学过程，以便更好地进行诊断和治疗。
本研究纳入了 44 名原发性闭角型青光眼（PACG）患者和 44 名健康对照者。使用 fMRI 数据和自动解剖标记 90 模板构建了功能性脑网络。随后，采用图论分析评估了全局度量、节点度量、模块组织和基于网络的统计分析（NBS），以对 PACG 患者和对照组进行比较分析。
全局度量（包括小世界和网络效率）的分析显示，两组之间没有显著差异。然而，PACG 患者的左额上内侧、右额上内侧和右后中央脑区的节点度量（如中心性和效率）升高，而右颞上回脑区的节点度量（如中心性和效率）降低。此外，模块 5 显示出模块内连接的明显差异，而模块 1 显示出与模块 7 和模块 8 的模块间连接的显著差异。值得注意的是，与健康对照组相比，NBS 分析显示 PACG 患者的网络存在显著改变。
本研究提出 PACG 患者的功能性大脑网络中存在节点度量和模块性的变化，特别是影响前额叶、枕叶和颞叶以及小脑区域。然而，对全局度量的分析表明，PACG 患者整个大脑网络的整体连接模式没有改变。这些结果有潜力成为 PACG 的早期诊断和鉴别标志物，针对具有高节点中心度和节点效率的脑区进行干预可能有助于优化治疗方法。
