Wang Yuanyuan, Xiong Chan, Li Shenghong, Li Jian, Wang Bo, Yan Meimei, Chen Jialu, Luo Zhijun, Zeng Xianjun
Department of Radiology, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, China.
Jiangxi Province Medical Imaging Research Institute, Nanchang, China.
Quant Imaging Med Surg. 2025 Jul 1;15(7):6053-6067. doi: 10.21037/qims-24-1947. Epub 2025 Jun 30.
A growing body of evidence suggests the presence of functional and structural abnormalities in patients with primary angle-closure glaucoma (PACG). The aim of this study was to examine the topological characteristics of the large-scale functional connectivity (FC) network, structural connectivity (SC) network, and strength of FC-SC coupling in patients with PACG.
This study included 47 patients with PACG and 48 healthy controls (HCs) matched for age, sex, and education. All participants underwent a detailed ophthalmological examination and cognitive assessment via the Montreal Cognitive Assessment scale. Resting-state functional magnetic resonance imaging and diffusion tensor imaging data of all participants were acquired separately. Large-scale FC and SC networks were constructed based on the Automated Anatomical Labeling 90 (AAL90) region atlas. Graph theoretic analysis was used for the computation of global attribute and node attribute indices. Subsequently, whole-brain FC-SC coupling was evaluated by analyzing the correspondence between FC and SC matrices to determine how brain anatomy constrains functional dynamics. Finally, the relationships between topological properties and coupling strengths with ophthalmic parameters and cognitive scales were assessed. Bonferroni correction was applied to all multiple comparisons.
Compared with the HC group, the PACG group had a lower normalized clustering coefficient (t=-2.339; P=0.024) and small-worldness (t=-2.017; P=0.047) for the FC network and lower normalized characteristic path length (t=-2.054; P=0.043) for the SC network. In terms of node attributes, the PACG group showed abnormal node degree, node betweenness, and node efficiency for FC and SC, mainly in the frontal, temporal, and occipital lobes. In addition, the strength of FC-SC coupling in the whole brain of patients with PACG was reduced (t=-2.622; P=0.01). The topological characteristics of these functional and structural abnormalities were correlated with visual acuity, disease duration, and Montreal Cognitive Assessment score (P<0.05).
We observed significantly weaker FC-SC coupling in patients with PACG compared to HCs, indicating impaired integration of brain structure and function. This decoupling suggests widespread network-level disruption, and this finding advances our understanding of optic nerve damage and cognitive deficits in PACG.
越来越多的证据表明原发性闭角型青光眼（PACG）患者存在功能和结构异常。本研究的目的是研究PACG患者大规模功能连接（FC）网络、结构连接（SC）网络的拓扑特征以及FC-SC耦合强度。
本研究纳入了47例PACG患者和48例年龄、性别及教育程度相匹配的健康对照（HC）。所有参与者均接受详细的眼科检查，并通过蒙特利尔认知评估量表进行认知评估。分别采集所有参与者的静息态功能磁共振成像和弥散张量成像数据。基于自动解剖标记90（AAL90）区域图谱构建大规模FC和SC网络。采用图论分析计算全局属性和节点属性指标。随后，通过分析FC和SC矩阵之间的对应关系评估全脑FC-SC耦合，以确定脑解剖结构如何约束功能动力学。最后，评估拓扑属性和耦合强度与眼科参数及认知量表之间的关系。对所有多重比较均应用Bonferroni校正。
与HC组相比，PACG组FC网络的归一化聚类系数（t=-2.339；P=0.024）和小世界性质（t=-2.017；P=0.047）较低，SC网络的归一化特征路径长度（t=-2.054；P=0.043）较低。在节点属性方面，PACG组FC和SC的节点度、节点介数和节点效率均异常，主要集中在额叶、颞叶和枕叶。此外，PACG患者全脑的FC-SC耦合强度降低（t=-2.622；P=0.01）。这些功能和结构异常的拓扑特征与视力、病程和蒙特利尔认知评估得分相关（P<0.05）。
我们观察到与HC相比，PACG患者的FC-SC耦合明显较弱，表明脑结构和功能的整合受损。这种解耦表明存在广泛的网络水平破坏，这一发现推进了我们对PACG患者视神经损伤和认知缺陷的理解。
