儿童弱视单眼遮盖治疗的脑可塑性多模态脑影像研究

Amblyopia, the result of long term irregular binocular input either due to anisometropia or strabismus during early life, is a disorder that causes disruption in the ability to focus in near visual space and switch between near/far visual spaces. It is currently thought that poor or blurred vision that occurs as a result of amblyopia is due to the underlying brain mechanism and not due to retina itself. Several studies have demonstrated cortical structural/functional abnormalities associated with amblyopia in adults. This proposal investigates the structural and functional connectivity before and after treatment in children 4-10 years of age. We hypothesize that the alterations in structural and functional connectivity before and after treatment can be measured. Recent studies in amblyopic population have demonstrated that although the visual cortex areas are the primary sites of reduced functional connectivity, disruption in structural and functional dysfunction at the level of lateral geneculate nucleus, thalamus and extra striatal regions have also been observed. Further, impairments in higher visual pathways responsible for spatial vision and recognition in parietal and temporal regions have been identified. These results suggest that amblyopia may not only be a disorder of visual acuity but also involve neural system dysfunction of visuo-motor coordination, visual guided navigation, visual decision marking, and visual attention. This raises the necessity for a technique that will allow studying multiple brain systems in the same dataset at an effective signal to noise ratio.

弱视是种由于幼年时期眼球斜视或屈光参差，导致眼-脑协调异常引发的病变，是我国青少年单眼视力障碍最主要因素。患者在没有得到及时有效治疗情况下，可能引起永久性单眼视力损伤甚至失明。然而，目前对于弱视的治疗多集中在其“眼”的部分，神经机制远远未明。我们前期成果显示，弱视人群脑功能异常并不仅限于低级视觉皮层，尚包含丘脑，纹状体皮层及顶叶，颞叶等负责高级视觉功能的皮层区域。因此，本项目拟通过无创的多模态神经成像技术，针对儿童弱视治疗前后脑可塑性变化来阐明这一科学问题，并从神经层面客观、量化、系统地评估治疗效果，同时更加深入理解弱视的病因及神经病理生理学机制。主要内容包括：（1）探究治疗对弱视儿童大脑结构功能的可塑性改变；（2）发展多模态神经影像融合分析方法，提供客观全面的神经影像学标记物用于评估治疗效果；（3）提出基于多模态神经影像机器学习的弱视治疗效果预测方法，为弱视儿童的临床治疗提供科学指导。

弱视是种由于幼年时期眼球斜视或屈光参差，导致眼-脑协调异常引发的病变，是我国青少年单眼视力障碍最主要因素。患者在没有得到及时有效治疗情况下，可能引起永久性单眼视力损伤甚至失明。然而，目前对于弱视的治疗多集中在患者“眼”部位，关于弱视患者脑影像异常改变的病理神经机制尚未完全阐明，相关研究仍处于初级探索阶段。.通过本项目的实施，收集包含儿童弱视治疗前后的多模态脑影像数据，以及多项临床视力数据。主要内容包括：（1）通过患者治疗前的脑自发低频振荡模式和脑结构异常改变研究，确定了弱视儿童脑功能/结构改变的关键脑区；（2）基于弱视患者脑功能和结构影像数据，发展多模态脑影像融合技术，全面揭示弱视儿童患者脑功能和结构改变，以及脑结构异常对脑功能活动的影响，极大地促进对弱视儿童全脑视觉功能紊乱的病理神经机制的理解；（3）通过探测上述脑功能和结构异常改变脑区与患者临床视力分数之间的内在联系，全面定量地刻画弱视患者视觉功能异常加工和与视觉相关的脑结构异常改变的神经机制，为弱视儿童的诊断及治疗提供科学指导。.当前共发表（含接收）SCI学术期刊论文共19篇，（10篇IF>5），学术期刊包括Journal of the American Academy of Child & Adolescent Psychiatry，Communications Biology，Human Brian Mapping，NeuroImage等。项目执行期间共培养硕士生5人，博士生3人。

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