Network Centrality of Resting-State fMRI in Primary Angle-Closure Glaucoma Before and After Surgery.
Network Centrality of Resting-State fMRI in Primary Angle-Closure Glaucoma Before and After Surgery.
复制标题
原发性闭角型青光眼手术前后静息态 fMRI 的网络中心性
DOI：
10.1371/journal.pone.0141389
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Huang R
中科院分区：
文献类型：
--
作者：
Cai F;Gao L;Gong H;Jiang F;Pei C;Zhang X;Zeng X;Huang R
目的利用静息态功能磁共振成像（fMRI）测量的体素向度中心性（DC），研究原发性闭角型青光眼（PACG）患者脑功能网络的改变，揭示手术的可塑性轨迹。方法对23例PACG患者（49.48 ± 14.37岁）术前进行静息态fMRI扫描，其中9例于术后3个月复查。所有PACG患者均接受了完整的眼科检查，包括眼压（IOP）、视网膜神经纤维层（RNFL）厚度、垂直杯盘比（VC/D）和平均杯盘比（AC/D）。另取23名年龄、性别相匹配的健康对照者（48.18 ± 9.40岁）进行一次扫描比较。计算每个体素DC的组间差异，并分析PACG患者DC值与每个临床变量之间的相关性。结果术前PACG患者双侧视皮层DC较对照组明显减少，而左侧前扣带回和尾状核DC较对照组明显增加（p < 0.05，校正后）。统计分析显示，PACG前患者双侧视皮质DC与IOP评分之间以及前扣带皮质（ACC）DC与A C/D和V C/D评分之间呈显着负相关。术后3个月，这些术后PACG（post-PACG）患者的双侧视皮层和左侧中央前回的DC均比术前PACG患者显著增加。结论PACG可能降低了视觉系统的功能中心性，增加了认知-情绪加工区域的程度中心性。视区的改变似乎与杯盘比平行，但与房角关闭的持续时间无关。PACG患者术后功能中心性的改变可能反映了视觉相关脑区的可塑性或变性。我们的研究结果可能提供进一步了解PACG的病理生理。
Purpose Using voxel-wise degree centrality (DC), as measured by resting-state fMRI, we aimed to study alterations in the brain functional networks in patients with primary angle-closure glaucoma (PACG) and to reveal the plastic trajectories of surgery. Methods A total of 23 preoperative PACG patients (49.48 ± 14.37 years old) were recruited to undergo a resting-state fMRI scan, and 9 of them were rescanned 3 months after surgery. All PACG patients underwent a complete ophthalmologic examination, including intraocular pressure (IOP), retinal nerve fiber layer (RNFL) thickness, vertical cup to disc ratio (V C/D), and average cup to disc ratio (A C/D). Another 23 gender- and age-matched healthy controls (48.18 ± 9.40 years old) underwent scanning once for comparison. The group difference in DC was calculated in each voxel, and the correlations between the DC value and each of the clinical variables were analyzed in the PACG patients. Results Preoperative PACG (pre-PACG) patients showed significantly decreased DC in the bilateral visual cortices but increased DC in the left anterior cingulate cortex (ACC) and caudate (p < 0.05, corrected) compared with the controls. Statistical analysis showed a significantly negative correlation between DC in the bilateral visual cortices and the IOP score and between DC in the anterior cingulate cortex (ACC) and both the A C/D and V C/D scores in the pre-PACG patients. Three months after surgery, these postoperative PACG (post-PACG) patients showed a significantly increased DC in both the bilateral visual cortices and the left precentral gyrus compared with the pre-PACG patients. Conclusions Our results suggest that PACG may contribute to decreased functional centrality in the visual system and to increased degree centrality in cognition-emotional processing regions. Alterations in visual areas seem to parallel the cup to disc ratio, but not the duration of angle closure. The changes of functional centrality in PACG patients after operation may reveal the plasticity or degeneration of the visual-associated brain areas. Our findings may provide further understanding of the pathophysiology of PACG.