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Klugah-Brown B, Bore MC, Liu X, Gan X, Biswal BB, Kendrick KM, Chang DHF, Zhou B, Becker B. The neurostructural consequences of glaucoma and their overlap with disorders exhibiting emotional dysregulations: A voxel-based meta-analysis and tripartite system model. J Affect Disord 2024; 358:487-499. [PMID: 38705527 DOI: 10.1016/j.jad.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Glaucoma, a progressive neurodegenerative disorder leading to irreversible blindness, is associated with heightened rates of generalized anxiety and depression. This study aims to comprehensively investigate brain morphological changes in glaucoma patients, extending beyond visual processing areas, and explores overlaps with morphological alterations observed in anxiety and depression. METHODS A comparative meta-analysis was conducted, using case-control studies of brain structural integrity in glaucoma patients. We aimed to identify regions with gray matter volume (GMV) changes, examine their role within distinct large-scale networks, and assess overlap with alterations in generalized anxiety disorder (GAD) and major depressive disorder (MDD). RESULTS Glaucoma patients exhibited significant GMV reductions in visual processing regions (lingual gyrus, thalamus). Notably, volumetric reductions extended beyond visual systems, encompassing the left putamen and insula. Behavioral and functional network decoding revealed distinct large-scale networks, implicating visual, motivational, and affective domains. The insular region, linked to pain and affective processes, displayed reductions overlapping with alterations observed in GAD. LIMITATIONS While the study identified significant morphological alterations, the number of studies from both the glaucoma and GAD cohorts remains limited due to the lack of independent studies meeting our inclusion criteria. CONCLUSION The study proposes a tripartite brain model for glaucoma, with visual processing changes related to the lingual gyrus and additional alterations in the putamen and insular regions tied to emotional or motivational functions. These neuroanatomical changes extend beyond the visual system, implying broader implications for brain structure and potential pathological developments, providing insights into the overall neurological consequences of glaucoma.
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Affiliation(s)
- Benjamin Klugah-Brown
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Mercy C Bore
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Xiqin Liu
- Department of Radiology and Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Xianyang Gan
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Bharat B Biswal
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; Department of Biomedical Engineering, New Jersey Institute of Technology, Newark, USA
| | - Keith M Kendrick
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China
| | - Dorita H F Chang
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Bo Zhou
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China.
| | - Benjamin Becker
- The Center of Psychosomatic Medicine, Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China; School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China; State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; Department of Psychology, The University of Hong Kong, Hong Kong, China.
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Beyer R, Al-Nosairy KO, Freitag C, Stolle FH, Behrens M, Prabhakaran GT, Thieme H, Schega L, Hoffmann MB. Treadmill-walking impairs visual function in early glaucoma and elderly controls. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06530-w. [PMID: 38856953 DOI: 10.1007/s00417-024-06530-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 05/09/2024] [Accepted: 05/22/2024] [Indexed: 06/11/2024] Open
Abstract
AIMS Impaired vision is an additional risk factor in elderly for falls. We investigated the hypothesis that treadmill (TM) walking affects visual function in both healthy elderly and those with early-moderate visual dysfunction due to glaucoma. METHODS Thirty healthy controls (HC) aged 64-83 years and 18 glaucoma patients (GLA) aged 62-82 years participated in this cross-sectional study. The impact of TM-walking on visual function was assessed binocularly for (i) best-corrected visual acuity (BCVA) with and without crowding effect, (ii) contrast sensitivity (CS), and (iii) and visual field (mean deviation, VF-MD). Visual function was tested while participants were standing or during TM-walking for 2 speed conditions: (i) fast walking at their preferred speed and (ii) walking at a fixed speed of 3.5 km/h. RESULTS GLA, most with early-moderate VF loss, performed equally well as HC. Independent of GROUP, an impact of SPEED on visual functions was statistically evident with large statistical effect size for (i) both types of BCVA with a mean loss of 0.02-0.05 logMAR (η2 = 0.41) and (ii) VF-MD with mean loss of 1 dB (η2 = 0.70), but not for CS. CONCLUSIONS Here, we introduce a paradigm for the assessment of visual function during walking. We provide proof-of-concept that our approach allows for the identification of walking induced visual function loss, i.e., a deterioration of BCVA and VF-sensitivity during TM-walking in both groups. It is therefore of promise for the investigation of the relation of vision impairment and mobility, ultimately the increased frequency of falls in advanced glaucoma.
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Affiliation(s)
- Rosalie Beyer
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Khaldoon O Al-Nosairy
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Constantin Freitag
- Department of Sport Science, Institute III, Otto Von Guericke University Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Francie H Stolle
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Martin Behrens
- Department of Sport Science, Institute III, Otto Von Guericke University Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
- University of Applied sciences for Sport and Management Potsdam, Olympischer Weg 7, 14471, Potsdam, Germany
| | - Gokulraj T Prabhakaran
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Hagen Thieme
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany
| | - Lutz Schega
- Department of Sport Science, Institute III, Otto Von Guericke University Magdeburg, Zschokkestraße 32, 39104, Magdeburg, Germany
| | - Michael B Hoffmann
- Ophthalmic Department, University Hospitals Magdeburg, Leipziger Str. 44, 39120, Magdeburg, Germany.
- Center for Behavioral Brain Research, Magdeburg, Germany.
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Rossinelli D, Fourestey G, Killer HE, Neutzner A, Iaccarino G, Remonda L, Berberat J. Large-scale in-silico analysis of CSF dynamics within the subarachnoid space of the optic nerve. Fluids Barriers CNS 2024; 21:20. [PMID: 38419077 PMCID: PMC10900650 DOI: 10.1186/s12987-024-00518-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Impaired cerebrospinal fluid (CSF) dynamics is involved in the pathophysiology of neurodegenerative diseases of the central nervous system and the optic nerve (ON), including Alzheimer's and Parkinson's disease, as well as frontotemporal dementia. The smallness and intricate architecture of the optic nerve subarachnoid space (ONSAS) hamper accurate measurements of CSF dynamics in this space, and effects of geometrical changes due to pathophysiological processes remain unclear. The aim of this study is to investigate CSF dynamics and its response to structural alterations of the ONSAS, from first principles, with supercomputers. METHODS Large-scale in-silico investigations were performed by means of computational fluid dynamics (CFD) analysis. High-order direct numerical simulations (DNS) have been carried out on ONSAS geometry at a resolution of 1.625 μm/pixel. Morphological changes on the ONSAS microstructure have been examined in relation to CSF pressure gradient (CSFPG) and wall strain rate, a quantitative proxy for mass transfer of solutes. RESULTS A physiological flow speed of 0.5 mm/s is achieved by imposing a hydrostatic pressure gradient of 0.37-0.67 Pa/mm across the ONSAS structure. At constant volumetric rate, the relationship between pressure gradient and CSF-accessible volume is well captured by an exponential curve. The ONSAS microstructure exhibits superior mass transfer compared to other geometrical shapes considered. An ONSAS featuring no microstructure displays a threefold smaller surface area, and a 17-fold decrease in mass transfer rate. Moreover, ONSAS trabeculae seem key players in mass transfer. CONCLUSIONS The present analysis suggests that a pressure drop of 0.1-0.2 mmHg over 4 cm is sufficient to steadily drive CSF through the entire subarachnoid space. Despite low hydraulic resistance, great heterogeneity in flow speeds puts certain areas of the ONSAS at risk of stagnation. Alterations of the ONSAS architecture aimed at mimicking pathological conditions highlight direct relationships between CSF volume and drainage capability. Compared to the morphological manipulations considered herein, the original ONSAS architecture seems optimized towards providing maximum mass transfer across a wide range of pressure gradients and volumetric rates, with emphasis on trabecular structures. This might shed light on pathophysiological processes leading to damage associated with insufficient CSF flow in patients with optic nerve compartment syndrome.
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Affiliation(s)
- Diego Rossinelli
- Institute for Computational and Mathematical Engineering (ICME), Center for Turbulence Research, Stanford University, Stanford, CA, 94305-3024, USA.
| | - Gilles Fourestey
- Scientific IT & Application Support (SCITAS), Swiss Federal Institute of Technology Lausanne (EPFL), Lausanne, Switzerland
| | | | - Albert Neutzner
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Gianluca Iaccarino
- Institute for Computational and Mathematical Engineering (ICME), Center for Turbulence Research, Stanford University, Stanford, CA, 94305-3024, USA
| | - Luca Remonda
- Institute of Neuroradiology, Kantonsspital Aarau, 5000, Aarau, Switzerland
| | - Jatta Berberat
- Institute of Neuroradiology, Kantonsspital Aarau, 5000, Aarau, Switzerland
- Geriatric Psychiatry, Department of Psychiatry, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
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Sharif NA. Identifying new drugs and targets to treat rapidly elevated intraocular pressure for angle closure and secondary glaucomas to curb visual impairment and prevent blindness. Exp Eye Res 2023; 232:109444. [PMID: 36958427 DOI: 10.1016/j.exer.2023.109444] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/23/2023] [Accepted: 03/16/2023] [Indexed: 03/25/2023]
Abstract
A multitude of pharmacological compounds have been shown to lower and control intraocular pressure (IOP) in numerous species of animals and human subjects after topical ocular dosing or via other routes of administration. Most researchers have been interested in finding drug candidates that exhibit a relatively long duration of action from a chronic therapeutic use perspective, for example to treat ocular hypertension (OHT), primary open-angle glaucoma and even normotensive glaucoma. However, it is equally important to seek and characterize treatment modalities which offer a rapid onset of action to help provide fast relief from quickly rising IOP that occurs in certain eye diseases. These include acute angle-closure glaucoma, primary angle-closure glaucoma, uveitic and inflammatory glaucoma, medication-induced OHT, and other secondary glaucomas induced by eye injury or infection which can cause partial or complete loss of eyesight. Such fast-acting agents can delay or prevent the need for ocular surgery which is often used to lower the dangerously raised IOP. This research survey was therefore directed at identifying agents from the literature that demonstrated ocular hypotensive activity, normalizing and unifying the data, determining their onset of action and rank ordering them on the basis of rapidity of action starting within 30-60 min and lasting up to at least 3-4 h post topical ocular dosing in different animal species. This research revealed a few health authority-approved drugs and some investigational compounds that appear to meet the necessary criteria of fast onset of action coupled with significant efficacy to reduce elevated IOP (by ≥ 20%, preferably by >30%). However, translation of the novel animal-based findings to the human conditions remains to be demonstrated but represent viable targets, especially EP2-receptor agonists (e.g. omidenepag isopropyl; AL-6598; butaprost), mixed activity serotonin/dopamine receptor agonists (e.g. cabergoline), rho kinase inhibitors (e.g. AMA0076, Y39983), CACNA2D1-gene product inhibitors (e.g. pregabalin), melatonin receptor agonists, and certain K+-channel openers (e.g. nicorandil, pinacidil). Other drug candidates and targets were also identified and will be discussed.
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Affiliation(s)
- Najam A Sharif
- Institute of Ophthalmology, University College London (UCL), London, UK; Imperial College of Science and Technology, St. Mary's Campus, London, UK; Eye-ACP Duke-National University of Singapore Medical School, Singapore; Singapore Eye Research Institute (SERI), Singapore; Department of Pharmacy Sciences, Creighton University, Omaha, NE, USA; Department of Pharmacology and Neuroscience, University of North Texas Health Sciences Center, Fort Worth, Texas, USA; Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Texas Southern University, Houston, Texas, USA; Ophthalmology Innovation Center, Santen Inc USA, Emeryville, CA, USA.
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Bang JW, Parra C, Yu K, Wollstein G, Schuman JS, Chan KC. GABA decrease is associated with degraded neural specificity in the visual cortex of glaucoma patients. Commun Biol 2023; 6:679. [PMID: 37386293 PMCID: PMC10310759 DOI: 10.1038/s42003-023-04918-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 05/05/2023] [Indexed: 07/01/2023] Open
Abstract
Glaucoma is an age-related neurodegenerative disease of the visual system, affecting both the eye and the brain. Yet its underlying metabolic mechanisms and neurobehavioral relevance remain largely unclear. Here, using proton magnetic resonance spectroscopy and functional magnetic resonance imaging, we investigated the GABAergic and glutamatergic systems in the visual cortex of glaucoma patients, as well as neural specificity, which is shaped by GABA and glutamate signals and underlies efficient sensory and cognitive functions. Our study shows that among the older adults, both GABA and glutamate levels decrease with increasing glaucoma severity regardless of age. Further, our study shows that the reduction of GABA but not glutamate predicts the neural specificity. This association is independent of the impairments on the retina structure, age, and the gray matter volume of the visual cortex. Our results suggest that glaucoma-specific decline of GABA undermines neural specificity in the visual cortex and that targeting GABA could improve the neural specificity in glaucoma.
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Affiliation(s)
- Ji Won Bang
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10017, USA.
| | - Carlos Parra
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10017, USA
| | - Kevin Yu
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10017, USA
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10017, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, New York, 10003, USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, New York, 11201, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10017, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, New York, 10003, USA
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, New York, 11201, USA
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10016, USA
| | - Kevin C Chan
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10017, USA.
- Center for Neural Science, College of Arts and Science, New York University, New York, New York, 10003, USA.
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, New York, 11201, USA.
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10016, USA.
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, 10016, USA.
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Sharif NA. Recently Approved Drugs for Lowering and Controlling Intraocular Pressure to Reduce Vision Loss in Ocular Hypertensive and Glaucoma Patients. Pharmaceuticals (Basel) 2023; 16:791. [PMID: 37375739 DOI: 10.3390/ph16060791] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 06/29/2023] Open
Abstract
Serious vision loss occurs in patients affected by chronically raised intraocular pressure (IOP), a characteristic of many forms of glaucoma where damage to the optic nerve components causes progressive degeneration of retinal and brain neurons involved in visual perception. While many risk factors abound and have been validated for this glaucomatous optic neuropathy (GON), the major one is ocular hypertension (OHT), which results from the accumulation of excess aqueous humor (AQH) fluid in the anterior chamber of the eye. Millions around the world suffer from this asymptomatic and progressive degenerative eye disease. Since clinical evidence has revealed a strong correlation between the reduction in elevated IOP/OHT and GON progression, many drugs, devices, and surgical techniques have been developed to lower and control IOP. The constant quest for new pharmaceuticals and other modalities with superior therapeutic indices has recently yielded health authority-approved novel drugs with unique pharmacological signatures and mechanism(s) of action and AQH drainage microdevices for effectively and durably treating OHT. A unique nitric oxide-donating conjugate of latanoprost, an FP-receptor prostaglandin (PG; latanoprostene bunod), new rho kinase inhibitors (ripasudil; netarsudil), a novel non-PG EP2-receptor-selective agonist (omidenepag isopropyl), and a form of FP-receptor PG in a slow-release intracameral implant (Durysta) represent the additions to the pharmaceutical toolchest to mitigate the ravages of OHT. Despite these advances, early diagnosis of OHT and glaucoma still lags behind and would benefit from further concerted effort and attention.
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Affiliation(s)
- Najam A Sharif
- Eye-APC Duke-NUS Medical School, Singapore 169856, Singapore
- Singapore Eye Research Institute, Singapore 169856, Singapore
- Department of Pharmacology and Neuroscience, University of North Texas Health Sciences Center, Fort Worth, TX 76107, USA
- Department of Pharmacy Sciences, Creighton University, Omaha, NE 68178, USA
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Texas Southern University, Houston, TX 77004, USA
- Imperial College of Science and Technology, St. Mary's Campus, London SW7 2BX, UK
- Institute of Ophthalmology, University College London, London WC1E 6BT, UK
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Sharif NA. Degeneration of retina-brain components and connections in glaucoma: Disease causation and treatment options for eyesight preservation. CURRENT RESEARCH IN NEUROBIOLOGY 2022; 3:100037. [PMID: 36685768 PMCID: PMC9846481 DOI: 10.1016/j.crneur.2022.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 01/25/2023] Open
Abstract
Eyesight is the most important of our sensory systems for optimal daily activities and overall survival. Patients who experience visual impairment due to elevated intraocular pressure (IOP) are often those afflicted with primary open-angle glaucoma (POAG) which slowly robs them of their vision unless treatment is administered soon after diagnosis. The hallmark features of POAG and other forms of glaucoma are damaged optic nerve, retinal ganglion cell (RGC) loss and atrophied RGC axons connecting to various brain regions associated with receipt of visual input from the eyes and eventual decoding and perception of images in the visual cortex. Even though increased IOP is the major risk factor for POAG, the disease is caused by many injurious chemicals and events that progress slowly within all components of the eye-brain visual axis. Lowering of IOP mitigates the damage to some extent with existing drugs, surgical and device implantation therapeutic interventions. However, since multifactorial degenerative processes occur during aging and with glaucomatous optic neuropathy, different forms of neuroprotective, nutraceutical and electroceutical regenerative and revitalizing agents and processes are being considered to combat these eye-brain disorders. These aspects form the basis of this short review article.
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Affiliation(s)
- Najam A. Sharif
- Duke-National University of Singapore Medical School, Singapore,Singapore Eye Research Institute (SERI), Singapore,Department of Pharmacology and Neuroscience, University of North Texas Health Sciences Center, Fort Worth, Texas, USA,Department of Pharmaceutical Sciences, Texas Southern University, Houston, TX, USA,Department of Surgery & Cancer, Imperial College of Science and Technology, St. Mary's Campus, London, UK,Department of Pharmacy Sciences, School of School of Pharmacy and Health Professions, Creighton University, Omaha, NE, USA,Ophthalmology Innovation Center, Santen Incorporated, 6401 Hollis Street (Suite #125), Emeryville, CA, 94608, USA,Ophthalmology Innovation Center, Santen Incorporated, 6401 Hollis Street (Suite #125), Emeryville, CA, 94608, USA.
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Fu Q, Liu H, Zhong YL. The Predictive Values of Changes in Local and Remote Brain Functional Connectivity in Primary Angle-Closure Glaucoma Patients According to Support Vector Machine Analysis. Front Hum Neurosci 2022; 16:910669. [PMID: 35664342 PMCID: PMC9160336 DOI: 10.3389/fnhum.2022.910669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 04/26/2022] [Indexed: 12/30/2022] Open
Abstract
Purpose The primary angle-closure glaucoma (PACG) is an irreversible blinding eye disease in the world. Previous neuroimaging studies demonstrated that PACG patients were associated with cerebral changes. However, the effect of optic atrophy on local and remote brain functional connectivity in PACG patients remains unknown. Materials and Methods In total, 23 patients with PACG and 23 well-matched Health Controls (HCs) were enrolled in our study and underwent resting-state functional magnetic resonance imaging (rs-fMRI) scanning. The regional homogeneity (ReHo) method and functional connectivity (FC) method were used to evaluate the local and remote brain functional connectivity. Moreover, support vector machine (SVM) method was applied to constructing PACG classification model. Results Compared with the HC, PACG patients showed increased ReHo values in right cerebellum (CER)_8, left CER_4-5, and right CER_8. In contrast, PACG patients showed decreased ReHo values in the bilateral lingual gyrus (LING)/calcarine (CAL)/superior occipital gyrus (SOG) and right postcentral gyrus (PostCG). The ReHo value exhibited an accuracy of 91.30% and area under curve (AUC) of 0.95 for distinguishing the PACG patients from HC. Conclusion Our study demonstrated that the PACG patients showed abnormal ReHo value in the cerebellum, visual cortex, and supplementary motor area, which might be reflect the neurological mechanisms underlying vision loss and eye pain in PACG patients. Moreover, the ReHo values can be used as a useful biomarker for distinguishing the PACG patients from HCs.
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Affiliation(s)
- Qiang Fu
- Department of Emergency, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Hui Liu
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
| | - Yu Lin Zhong
- Department of Ophthalmology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, China
- *Correspondence: Yu Lin Zhong,
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Mendoza M, Shotbolt M, Faiq MA, Parra C, Chan KC. Advanced Diffusion MRI of the Visual System in Glaucoma: From Experimental Animal Models to Humans. BIOLOGY 2022; 11:biology11030454. [PMID: 35336827 PMCID: PMC8945790 DOI: 10.3390/biology11030454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 03/10/2022] [Indexed: 11/18/2022]
Abstract
Simple Summary This review summarizes current applications of advanced diffusion magnetic resonance imaging (MRI) throughout the glaucomatous visual system, focusing on the eye, optic nerve, optic tract, subcortical visual brain nuclei, optic radiations, and visual cortex. Glaucoma continues to be the leading cause of irreversible blindness worldwide and often remains undetected until later disease stages. The development of non-invasive methods for early detection of visual pathway integrity could pave the way for timely intervention and targeted treatment strategies. Principles of diffusion have been integrated with MRI protocols to produce a diffusion-weighted imaging modality for studying changes to tissue microstructures by quantifying the movement of water molecules in vivo. The development and applications of diffusion MRI in ophthalmology have allowed a better understanding of neural pathway changes in glaucoma. The feasibility of translating diffusion MRI techniques to assess both humans and experimental animal models of glaucoma and other optic neuropathies or neurodegenerative diseases is discussed. Recent research focuses on overcoming limitations in imaging quality, acquisition times, and biological interpretation suggest that diffusion MRI can provide an important tool for the non-invasive evaluation of glaucomatous changes in the visual system. Abstract Glaucoma is a group of ophthalmologic conditions characterized by progressive retinal ganglion cell death, optic nerve degeneration, and irreversible vision loss. While intraocular pressure is the only clinically modifiable risk factor, glaucoma may continue to progress at controlled intraocular pressure, indicating other major factors in contributing to the disease mechanisms. Recent studies demonstrated the feasibility of advanced diffusion magnetic resonance imaging (dMRI) in visualizing the microstructural integrity of the visual system, opening new possibilities for non-invasive characterization of glaucomatous brain changes for guiding earlier and targeted intervention besides intraocular pressure lowering. In this review, we discuss dMRI methods currently used in visual system investigations, focusing on the eye, optic nerve, optic tract, subcortical visual brain nuclei, optic radiations, and visual cortex. We evaluate how conventional diffusion tensor imaging, higher-order diffusion kurtosis imaging, and other extended dMRI techniques can assess the neuronal and glial integrity of the visual system in both humans and experimental animal models of glaucoma, among other optic neuropathies or neurodegenerative diseases. We also compare the pros and cons of these methods against other imaging modalities. A growing body of dMRI research indicates that this modality holds promise in characterizing early glaucomatous changes in the visual system, determining the disease severity, and identifying potential neurotherapeutic targets, offering more options to slow glaucoma progression and to reduce the prevalence of this world’s leading cause of irreversible but preventable blindness.
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Affiliation(s)
- Monica Mendoza
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
| | - Max Shotbolt
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
| | - Muneeb A. Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
| | - Carlos Parra
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
| | - Kevin C. Chan
- Department of Biomedical Engineering, Tandon School of Engineering, New York University, New York, NY 11201, USA; (M.M.); (M.S.)
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10017, USA; (M.A.F.); (C.P.)
- Department of Radiology, Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY 10016, USA
- Correspondence:
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10
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Demaria G, Invernizzi A, Ombelet D, Carvalho JC, Renken RJ, Cornelissen FW. Binocular Integrated Visual Field Deficits Are Associated With Changes in Local Network Function in Primary Open-Angle Glaucoma: A Resting-State fMRI Study. Front Aging Neurosci 2022; 13:744139. [PMID: 35095465 PMCID: PMC8792402 DOI: 10.3389/fnagi.2021.744139] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
In glaucoma participants, both structural and functional brain changes have been observed, but we still have insufficient understanding of how these changes also affect the integrity of cortical functional networks, and how these changes relate to visual function. This is relevant, as functional network integrity may affect the applicability of future treatments, as well as the options for rehabilitation or training. Here, we compare global and local functional connectivity in local and global brain networks between glaucoma and control participants. Moreover, we study the relationship between functional connectivity and visual field (VF) loss. For our study, 20 subjects with primary open-angle glaucoma (POAG) and 24 age-similar healthy participants were recruited to undergo an ophthalmic assessment followed by two resting-state (RS) (f)MRI scans. For each scan and for each group, the ROIs with eigenvector centrality (EC) values higher than the 95th percentile were considered the most central brain regions (“hubs”). Hubs for which we found a significant difference in EC in both scans between glaucoma and healthy participants were considered to provide evidence for network changes. In addition, we tested the notion that a brain region's hub function in POAG might relate to the severity of a participant's VF defect, irrespective of which eye contributed mostly to this. To determine this, for each participant, eye-independent scores were derived for: (1) sensitivity of the worse eye – indicating disease severity, (2) sensitivity of both eyes combined – with one eye potentially compensating for loss in the other, or (3) difference in eye sensitivity – potentially requiring additional network interactions. By correlating each of these VF scores and the EC values, we assessed whether VF defects could be associated with centrality alterations in POAG. Our results show that no functional connectivity disruptions were found at the global brain level in POAG participants. This indicates that in glaucoma global brain network communication is preserved. Furthermore, for the Lingual Gyrus, identified as a brain hub, we found a positive correlation between the EC value and the VF sensitivity of both eyes combined. The fact that reduced local network functioning is associated with reduced binocular VF sensitivity suggests the presence of local brain reorganization that has a bearing on functional visual abilities.
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Affiliation(s)
- Giorgia Demaria
- Laboratory of Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- *Correspondence: Giorgia Demaria
| | - Azzurra Invernizzi
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Daniel Ombelet
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Joana C. Carvalho
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Remco J. Renken
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
| | - Frans W. Cornelissen
- Laboratory of Experimental Ophthalmology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Cognitive Neuroscience Center, Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, Groningen, Netherlands
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11
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Sims JR, Chen AM, Sun Z, Deng W, Colwell NA, Colbert MK, Zhu J, Sainulabdeen A, Faiq MA, Bang JW, Chan KC. Role of Structural, Metabolic, and Functional MRI in Monitoring Visual System Impairment and Recovery. J Magn Reson Imaging 2021; 54:1706-1729. [PMID: 33009710 PMCID: PMC8099039 DOI: 10.1002/jmri.27367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 08/24/2020] [Accepted: 08/27/2020] [Indexed: 12/13/2022] Open
Abstract
The visual system, consisting of the eyes and the visual pathways of the brain, receives and interprets light from the environment so that we can perceive the world around us. A wide variety of disorders can affect human vision, ranging from ocular to neurologic to systemic in nature. While other noninvasive imaging techniques such as optical coherence tomography and ultrasound can image particular sections of the visual system, magnetic resonance imaging (MRI) offers high resolution without depth limitations. MRI also gives superior soft-tissue contrast throughout the entire pathway compared to computed tomography. By leveraging different imaging sequences, MRI is uniquely capable of unveiling the intricate processes of ocular anatomy, tissue physiology, and neurological function in the human visual system from the microscopic to macroscopic levels. In this review we discuss how structural, metabolic, and functional MRI can be used in the clinical assessment of normal and pathologic states in the anatomic structures of the visual system, including the eyes, optic nerves, optic chiasm, optic tracts, visual brain nuclei, optic radiations, and visual cortical areas. We detail a selection of recent clinical applications of MRI at each position along the visual pathways, including the evaluation of pathology, plasticity, and the potential for restoration, as well as its limitations and key areas of ongoing exploration. Our discussion of the current and future developments in MR ocular and neuroimaging highlights its potential impact on our ability to understand visual function in new detail and to improve our protection and treatment of anatomic structures that are integral to this fundamental sensory system. LEVEL OF EVIDENCE 3: TECHNICAL EFFICACY STAGE 3: .
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Affiliation(s)
- Jeffrey R. Sims
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Anna M. Chen
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Sackler Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Zhe Sun
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Sackler Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Wenyu Deng
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Nicole A. Colwell
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Max K. Colbert
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Jingyuan Zhu
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Anoop Sainulabdeen
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Department of Surgery and Radiology, College of Veterinary and Animal Sciences, Kerala Veterinary and Animal Sciences University, Thrissur, India
| | - Muneeb A. Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Ji Won Bang
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
| | - Kevin C. Chan
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Sackler Institute of Graduate Biomedical Sciences, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, New York, USA
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12
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Sharif NA. Therapeutic Drugs and Devices for Tackling Ocular Hypertension and Glaucoma, and Need for Neuroprotection and Cytoprotective Therapies. Front Pharmacol 2021; 12:729249. [PMID: 34603044 PMCID: PMC8484316 DOI: 10.3389/fphar.2021.729249] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022] Open
Abstract
Damage to the optic nerve and the death of associated retinal ganglion cells (RGCs) by elevated intraocular pressure (IOP), also known as glaucoma, is responsible for visual impairment and blindness in millions of people worldwide. The ocular hypertension (OHT) and the deleterious mechanical forces it exerts at the back of the eye, at the level of the optic nerve head/optic disc and lamina cribosa, is the only modifiable risk factor associated with glaucoma that can be treated. The elevated IOP occurs due to the inability of accumulated aqueous humor (AQH) to egress from the anterior chamber of the eye due to occlusion of the major outflow pathway, the trabecular meshwork (TM) and Schlemm’s canal (SC). Several different classes of pharmaceutical agents, surgical techniques and implantable devices have been developed to lower and control IOP. First-line drugs to promote AQH outflow via the uveoscleral outflow pathway include FP-receptor prostaglandin (PG) agonists (e.g., latanoprost, travoprost and tafluprost) and a novel non-PG EP2-receptor agonist (omidenepag isopropyl, Eybelis®). TM/SC outflow enhancing drugs are also effective ocular hypotensive agents (e.g., rho kinase inhibitors like ripasudil and netarsudil; and latanoprostene bunod, a conjugate of a nitric oxide donor and latanoprost). One of the most effective anterior chamber AQH microshunt devices is the Preserflo® microshunt which can lower IOP down to 10–13 mmHg. Other IOP-lowering drugs and devices on the horizon will be also discussed. Additionally, since elevated IOP is only one of many risk factors for development of glaucomatous optic neuropathy, a treatise of the role of inflammatory neurodegeneration of the optic nerve and retinal ganglion cells and appropriate neuroprotective strategies to mitigate this disease will also be reviewed and discussed.
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Affiliation(s)
- Najam A Sharif
- Global Alliances and External Research, Ophthalmology Innovation Center, Santen Inc., Emeryville, CA, United States
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13
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Colbert MK, Ho LC, van der Merwe Y, Yang X, McLellan GJ, Hurley SA, Field AS, Yun H, Du Y, Conner IP, Parra C, Faiq MA, Fingert JH, Wollstein G, Schuman JS, Chan KC. Diffusion Tensor Imaging of Visual Pathway Abnormalities in Five Glaucoma Animal Models. Invest Ophthalmol Vis Sci 2021; 62:21. [PMID: 34410298 PMCID: PMC8383913 DOI: 10.1167/iovs.62.10.21] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose To characterize the visual pathway integrity of five glaucoma animal models using diffusion tensor imaging (DTI). Methods Two experimentally induced and three genetically determined models of glaucoma were evaluated. For inducible models, chronic IOP elevation was achieved via intracameral injection of microbeads or laser photocoagulation of the trabecular meshwork in adult rodent eyes. For genetic models, the DBA/2J mouse model of pigmentary glaucoma, the LTBP2 mutant feline model of congenital glaucoma, and the transgenic TBK1 mouse model of normotensive glaucoma were compared with their respective genetically matched healthy controls. DTI parameters, including fractional anisotropy, axial diffusivity, and radial diffusivity, were evaluated along the optic nerve and optic tract. Results Significantly elevated IOP relative to controls was observed in each animal model except for the transgenic TBK1 mice. Significantly lower fractional anisotropy and higher radial diffusivity were observed along the visual pathways of the microbead- and laser-induced rodent models, the DBA/2J mice, and the LTBP2-mutant cats compared with their respective healthy controls. The DBA/2J mice also exhibited lower axial diffusivity, which was not observed in the other models examined. No apparent DTI change was observed in the transgenic TBK1 mice compared with controls. Conclusions Chronic IOP elevation was accompanied by decreased fractional anisotropy and increased radial diffusivity along the optic nerve or optic tract, suggestive of disrupted microstructural integrity in both inducible and genetic glaucoma animal models. The effects on axial diffusivity differed between models, indicating that this DTI metric may represent different aspects of pathological changes over time and with severity.
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Affiliation(s)
- Max K Colbert
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - Leon C Ho
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Yolandi van der Merwe
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Xiaoling Yang
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Gillian J McLellan
- Department of Ophthalmology and Visual Sciences, University of Wisconsin - Madison, Madison, Wisconsin, United States.,McPherson Eye Research Institute, University of Wisconsin - Madison, Madison, Wisconsin, United States
| | - Samuel A Hurley
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, United States
| | - Aaron S Field
- Department of Radiology, University of Wisconsin - Madison, Madison, Wisconsin, United States
| | - Hongmin Yun
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Yiqin Du
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Ian P Conner
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, United States
| | - Carlos Parra
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - Muneeb A Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - John H Fingert
- Department of Ophthalmology and Visual Sciences, University of Iowa College of Medicine, Iowa City, Iowa, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States
| | - Joel S Schuman
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States.,Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
| | - Kevin C Chan
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Center for Neural Science, College of Arts and Science, New York University, New York, New York, United States.,Department of Biomedical Engineering, New York University Tandon School of Engineering, Brooklyn, New York, United States.,Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States.,Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, New York, United States
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14
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Nuzzi R, Vitale A. Cerebral Modifications in Glaucoma and Macular Degeneration: Analysis of Current Evidence in Literature and Their Implications on Therapeutic Perspectives. Eye Brain 2021; 13:159-173. [PMID: 34168513 PMCID: PMC8216745 DOI: 10.2147/eb.s307551] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 04/14/2021] [Indexed: 01/19/2023] Open
Abstract
Glaucoma and macular degeneration are leading causes of irreversible blindness, significantly compromising the quality of life and having a high economic and social impact. Promising therapeutic approaches aimed at regenerating or bypassing the damaged anatomical-functional components are currently under development: these approaches have generated great expectations, but to be effective require a visual network that, despite the pathology, maintains its integrity up to the higher brain areas. In the light of this, the existing findings concerning how the central nervous system modifies its connections following the pathological damage caused by glaucoma and macular degeneration acquire great interest. This review aims to examine the scientific literature concerning the morphological and functional changes affecting the central nervous system in these pathological conditions, summarizing the evidence in an analytical way, discussing their possible causes and highlighting the potential repercussions on the current therapeutic perspectives.
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Affiliation(s)
- Raffaele Nuzzi
- Eye Clinic, Department of Surgical Sciences, University of Turin, Turin, 10126, Italy
| | - Alessio Vitale
- Eye Clinic, Department of Surgical Sciences, University of Turin, Turin, 10126, Italy
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15
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You M, Rong R, Zeng Z, Xia X, Ji D. Transneuronal Degeneration in the Brain During Glaucoma. Front Aging Neurosci 2021; 13:643685. [PMID: 33889083 PMCID: PMC8055862 DOI: 10.3389/fnagi.2021.643685] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/11/2021] [Indexed: 12/18/2022] Open
Abstract
The death of retinal ganglion cells (RGCs) is a key factor in the pathophysiology of all types of glaucoma, but the mechanism of pathogenesis of glaucoma remains unclear. RGCs are a group of central nervous system (CNS) neurons whose soma are in the inner retina. The axons of RGCs form the optic nerve and converge at the optic chiasma; from there, they project to the visual cortex via the lateral geniculate nucleus (LGN). In recent years, there has been increasing interest in the dysfunction and death of CNS and retinal neurons caused by transneuronal degeneration of RGCs, and the view that glaucoma is a widespread neurodegenerative disease involving CNS damage appears more and more frequently in the literature. In this review, we summarize the current knowledge of LGN and visual cortex neuron damage in glaucoma and possible mechanisms behind the damage. This review presents an updated and expanded view of neuronal damage in glaucoma, and reveals new and potential targets for neuroprotection and treatment.
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Affiliation(s)
- Mengling You
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Rong Rong
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Zhou Zeng
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Xiaobo Xia
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
| | - Dan Ji
- Department of Ophthalmology, Xiangya Hospital, Central South University, Changsha, China.,Hunan Key Laboratory of Ophthalmology, Changsha, China
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16
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Wang Q, Qu X, Chen W, Wang H, Huang C, Li T, Wang N, Xian J. Altered coupling of cerebral blood flow and functional connectivity strength in visual and higher order cognitive cortices in primary open angle glaucoma. J Cereb Blood Flow Metab 2021; 41:901-913. [PMID: 32580669 PMCID: PMC7983497 DOI: 10.1177/0271678x20935274] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 01/30/2023]
Abstract
Primary open-angle glaucoma (POAG) has been suggested to be a neurodegenerative disease associated with altered cerebral vascular hemodynamics and widespread disruption of neuronal activity within the visual, working memory, attention and executive networks. We hypothesized that disturbed neurovascular coupling in visual and higher order cognitive cortices exists in POAG patients and correlates with glaucoma stage and visual field defects. Through multimodal magnetic resonance imaging, we evaluated the cerebral blood flow (CBF)-functional connectivity strength (FCS) correlations of the whole gray matter and CBF/FCS ratio per voxel for all subjects. Compared with normal controls, POAG patients showed reduced global CBF-FCS coupling and altered CBF/FCS ratios, predominantly in regions in the visual cortex, salience network, default mode network, and dorsal attentional network. The CBF/FCS ratio was negatively correlated with glaucoma stage, and positively correlated with visual field defects in the lingual gyrus in POAG patients. Moreover, early brain changes were detected in early POAG. These findings indicate neurovascular coupling dysfunction might exist in the visual and higher order cognitive cortices in POAG patients and its clinical relevance. The results may contribute to the monitoring of POAG progression and provide insight into the pathophysiology of the neurodegenerative process in POAG.
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Affiliation(s)
- Qian Wang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Qu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Weiwei Chen
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Huaizhou Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Caiyun Huang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ting Li
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
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17
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van der Merwe Y, Murphy MC, Sims JR, Faiq MA, Yang XL, Ho LC, Conner IP, Yu Y, Leung CK, Wollstein G, Schuman JS, Chan KC. Citicoline Modulates Glaucomatous Neurodegeneration Through Intraocular Pressure-Independent Control. Neurotherapeutics 2021; 18:1339-1359. [PMID: 33846961 PMCID: PMC8423893 DOI: 10.1007/s13311-021-01033-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 02/08/2023] Open
Abstract
Glaucoma is a neurodegenerative disease that causes progressive, irreversible vision loss. Currently, intraocular pressure (IOP) is the only modifiable risk factor for glaucoma. However, glaucomatous degeneration may continue despite adequate IOP control. Therefore, there exists a need for treatment that protects the visual system, independent of IOP. This study sought, first, to longitudinally examine the neurobehavioral effects of different magnitudes and durations of IOP elevation using multi-parametric magnetic resonance imaging (MRI), optokinetics and histology; and, second, to evaluate the effects of oral citicoline treatment as a neurotherapeutic in experimental glaucoma. Eighty-two adult Long Evans rats were divided into six groups: acute (mild or severe) IOP elevation, chronic (citicoline-treated or untreated) IOP elevation, and sham (acute or chronic) controls. We found that increasing magnitudes and durations of IOP elevation differentially altered structural and functional brain connectivity and visuomotor behavior, as indicated by decreases in fractional anisotropy in diffusion tensor MRI, magnetization transfer ratios in magnetization transfer MRI, T1-weighted MRI enhancement of anterograde manganese transport, resting-state functional connectivity, visual acuity, and neurofilament and myelin staining along the visual pathway. Furthermore, 3 weeks of oral citicoline treatment in the setting of chronic IOP elevation significantly reduced visual brain integrity loss and visual acuity decline without altering IOP. Such effects sustained after treatment was discontinued for another 3 weeks. These results not only illuminate the close interplay between eye, brain, and behavior in glaucomatous neurodegeneration, but also support a role for citicoline in protecting neural tissues and visual function in glaucoma beyond IOP control.
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Affiliation(s)
- Yolandi van der Merwe
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Matthew C Murphy
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Jeffrey R Sims
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Muneeb A Faiq
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Xiao-Ling Yang
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Leon C Ho
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ian P Conner
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yu Yu
- Pleryon Therapeutics Limited, Shenzhen, China
| | - Christopher K Leung
- University Eye Center, Hong Kong Eye Hospital, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA
| | - Joel S Schuman
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
- Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA
| | - Kevin C Chan
- UPMC Eye Center, Eye and Ear Institute, Ophthalmology and Visual Science Research Center, Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Bioengineering, Swanson School of Engineering, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Ophthalmology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
- Center for Neural Science, College of Arts and Science, New York University, New York, NY, USA.
- Department of Radiology, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
- Neuroscience Institute, NYU Grossman School of Medicine, NYU Langone Health, New York University, New York, NY, USA.
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18
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Hanekamp S, Ćurčić-Blake B, Caron B, McPherson B, Timmer A, Prins D, Boucard CC, Yoshida M, Ida M, Hunt D, Jansonius NM, Pestilli F, Cornelissen FW. White matter alterations in glaucoma and monocular blindness differ outside the visual system. Sci Rep 2021; 11:6866. [PMID: 33767217 PMCID: PMC7994383 DOI: 10.1038/s41598-021-85602-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 02/15/2021] [Indexed: 01/23/2023] Open
Abstract
The degree to which glaucoma has effects in the brain beyond the eye and the visual pathways is unclear. To clarify this, we investigated white matter microstructure (WMM) in 37 tracts of patients with glaucoma, monocular blindness, and controls. We used brainlife.io for reproducibility. White matter tracts were subdivided into seven categories ranging from those primarily involved in vision (the visual white matter) to those primarily involved in cognition and motor control. In the vision tracts, WMM was decreased as measured by fractional anisotropy in both glaucoma and monocular blind subjects compared to controls, suggesting neurodegeneration due to reduced sensory inputs. A test-retest approach was used to validate these results. The pattern of results was different in monocular blind subjects, where WMM properties increased outside the visual white matter as compared to controls. This pattern of results suggests that whereas in the monocular blind loss of visual input might promote white matter reorganization outside of the early visual system, such reorganization might be reduced or absent in glaucoma. The results provide indirect evidence that in glaucoma unknown factors might limit the reorganization as seen in other patient groups following visual loss.
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Affiliation(s)
- Sandra Hanekamp
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.
- Department of Intelligent Systems Engineering, Luddy School of Informatics and Engineering, Indiana University, Bloomington, IN, USA.
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA.
| | - Branislava Ćurčić-Blake
- Department of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bradley Caron
- Program in Neuroscience, Indiana University, Bloomington, IN, USA
- Program in Vision Science, School of Optometry, Indiana University, Bloomington, IN, USA
| | - Brent McPherson
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Anneleen Timmer
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Doety Prins
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Christine C Boucard
- Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan
| | - Masaki Yoshida
- Department of Ophthalmology, Jikei University School of Medicine, Tokyo, Japan
| | - Masahiro Ida
- Department of Radiology, National Hospital Organization Mito Medical Center, Ibaraki, Japan
| | - David Hunt
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Nomdo M Jansonius
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Franco Pestilli
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA.
- Department of Intelligent Systems Engineering, Luddy School of Informatics and Engineering, Indiana University, Bloomington, IN, USA.
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA.
- Program in Neuroscience, Indiana University, Bloomington, IN, USA.
- Program in Vision Science, School of Optometry, Indiana University, Bloomington, IN, USA.
| | - Frans W Cornelissen
- Laboratory for Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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19
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The Consequences of Glaucoma on Mobility and Balance Control in the Older Adults: A Cross-Sectional Study. J Aging Phys Act 2020; 29:372-381. [PMID: 32994380 DOI: 10.1123/japa.2020-0079] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 07/09/2020] [Accepted: 07/17/2020] [Indexed: 11/18/2022]
Abstract
The aim of the study was to explore the functional impairments and related factors in older adults with moderate to advanced stages of glaucoma. Nineteen patients with glaucoma and 19 participants with no ocular disease performed step test and balance control tasks with analysis of overall stability index and fall risk index. Monocular and binocular Humphrey Visual Field tests were used to estimate visual field defect severity. The International Physical Activity Questionnaire was used to measure physical activity level. Patients with glaucoma showed poorer values for most of the mobility and balance control parameters with medium and large effect sizes (0.3-0.5). Mobility scores in patients were partly associated with their monocular visual field defect (rs = .507, p < .05). Low physical activity was identified as a risk factor for falls (rs = -.453, p < .05) and postural instability (rs = -.457, p < .05). Functional declines in dynamic tasks were not related to glaucoma severity. Older adults with glaucoma display impairment with mobility and balance control compared to controls, associated with the degree of monocular visual field loss and lower daily physical activity.
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20
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Nucci C, Garaci F, Altobelli S, Di Ciò F, Martucci A, Aiello F, Lanzafame S, Di Giuliano F, Picchi E, Minosse S, Cesareo M, Guerrisi MG, Floris R, Passamonti L, Toschi N. Diffusional Kurtosis Imaging of White Matter Degeneration in Glaucoma. J Clin Med 2020; 9:jcm9103122. [PMID: 32992559 PMCID: PMC7600134 DOI: 10.3390/jcm9103122] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 09/18/2020] [Accepted: 09/23/2020] [Indexed: 02/06/2023] Open
Abstract
Glaucoma is an optic neuropathy characterized by death of retinal ganglion cells and loss of their axons, progressively leading to blindness. Recently, glaucoma has been conceptualized as a more diffuse neurodegenerative disorder involving the optic nerve and also the entire brain. Consistently, previous studies have used a variety of magnetic resonance imaging (MRI) techniques and described widespread changes in the grey and white matter of patients. Diffusion kurtosis imaging (DKI) provides additional information as compared with diffusion tensor imaging (DTI), and consistently provides higher sensitivity to early microstructural white matter modification. In this study, we employ DKI to evaluate differences among healthy controls and a mixed population of primary open angle glaucoma patients ranging from stage I to V according to Hodapp–Parrish–Anderson visual field impairment classification. To this end, a cohort of patients affected by primary open angle glaucoma (n = 23) and a group of healthy volunteers (n = 15) were prospectively enrolled and underwent an ophthalmological evaluation followed by magnetic resonance imaging (MRI) using a 3T MR scanner. After estimating both DTI indices, whole-brain, voxel-wise statistical comparisons were performed in white matter using Tract-Based Spatial Statistics (TBSS). We found widespread differences in several white matter tracts in patients with glaucoma relative to controls in several metrics (mean kurtosis, kurtosis anisotropy, radial kurtosis, and fractional anisotropy) which involved localization well beyond the visual pathways, and involved cognitive, motor, face recognition, and orientation functions amongst others. Our findings lend further support to a causal brain involvement in glaucoma and offer alternative explanations for a number of multidomain impairments often observed in glaucoma patients.
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Affiliation(s)
- Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
- San Raffaele Cassino, 03043 Frosinone, Italy
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Simone Altobelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Francesco Aiello
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, 00133 Rome, Italy; (A.M.); (F.A.); (M.C.)
| | - Maria Giovanna Guerrisi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy;
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, 20090 Milano, Italy
- Department of Clinical Neurosciences, University of Cambridge, Cambridge CB2 0QQ, UK
- Correspondence: (C.N.); (F.G.); (L.P.); Tel.: +39-06-7259-6145 (C.N.); +39-06-2090-2471 (F.G.); +44-01223-330293 (L.P.)
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy; (S.A.); (F.D.C.); (S.L.); (E.P.); (S.M.); (M.G.G.); (N.T.)
- Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, 149 13th Street, Boston, MA 02129, USA
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21
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Di Ciò F, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Di Giuliano F, Picchi E, Cesareo M, Guerrisi MG, Floris R, Nucci C, Toschi N. Reorganization of the structural connectome in primary open angle Glaucoma. Neuroimage Clin 2020; 28:102419. [PMID: 33032067 PMCID: PMC7552094 DOI: 10.1016/j.nicl.2020.102419] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 09/04/2020] [Accepted: 09/06/2020] [Indexed: 12/18/2022]
Abstract
Primary open angle Glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have suggested the hypothesis that POAG is also a central nervous system disorder which may result in additional (i.e., extra-ocular) involvement. The aim of this study is to assess possible structural, whole-brain connectivity alterations in POAG patients. We evaluated 23 POAG patients and 15 healthy controls by combining multi-shell diffusion weighted imaging, multi-shell, multi-tissue probabilistic tractography, graph theoretical measures and a recently designed 'disruption index', which evaluates the global reorganization of brain networks. We also studied the associations between the whole-brain structural connectivity measures and indices of visual acuity including the field index (VFI) and two Optical Coherence Tomography (OCT) parameters, namely the Macula Ganglion Cell Layer (MaculaGCL) and Retinal Nerve Fiber Layer (RNFL) thicknesses. We found both global and local structural connectivity differences between POAG patients and controls, which extended well beyond the primary visual pathway and were localized in the left calcarine gyrus (clustering coefficient p = 0.036), left lateral occipital cortex (clustering coefficient p = 0.017, local efficiency p = 0.035), right lingual gyrus (clustering coefficient p = 0.009), and right paracentral lobule (clustering coefficient p = 0.009, local efficiency p = 0.018). Group-wise (clustering coefficient, p = 6.59∙10-7 and local efficiency p = 6.23·10-8) and subject-wise disruption indices (clustering coefficient, p = 0.018 and local efficiency, p = 0.01) also differed between POAG patients and controls. In addition, we found negative associations between RNFL thickness and local measures (clustering coefficient, local efficiency and strength) in the right amygdala (local efficiency p = 0.008, local strength p = 0.016), right inferior temporal gyrus (clustering coefficient p = 0.036, local efficiency p = 0.042), and right temporal pole (local strength p = 0.008). Overall, we show, in patients with POAG, a whole-brain structural reorganization that spans across a variety of brain regions involved in visual processing, motor control, and emotional/cognitive functions. We also identified a pattern of brain structural changes in relation to POAG clinical severity. Taken together, our findings support the hypothesis that the reduction in visual acuity from POAG can be driven by a combination of local (i.e., in the eye) and more extended (i.e., brain) effects.
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Affiliation(s)
- Francesco Di Ciò
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy.
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy; San Raffaele Cassino, Frosinone, Italy
| | - Silvia Minosse
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Luca Passamonti
- Institute of Bioimaging and Molecular Physiology, National Research Council, Milano, Italy; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
| | - Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Simona Lanzafame
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Maria Giovanna Guerrisi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Italy; Athinoula A. Martinos Center for Biomedical Imaging and Harvard Medical School, Boston, MA, USA.
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22
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Martucci A, Cesareo M, Toschi N, Garaci F, Bagetta G, Nucci C. Brain networks reorganization and functional disability in glaucoma. PROGRESS IN BRAIN RESEARCH 2020; 257:65-76. [PMID: 32988473 DOI: 10.1016/bs.pbr.2020.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Glaucoma is an optic neuropathy characterized by progressive loss of retinal ganglion cells with associated structural and functional changes of the optic nerve head and retinal nerve fiber layer. However, recent studies employing advanced neuroimaging techniques confirmed that glaucomatous damage is not limited to the eye but extends to the brain, affecting it also beyond the central visual pathways and disrupting brain network organization. We therefore posit that, while visual field changes play an important role in glaucoma-induced disability, central nervous pathways and mechanisms may play an important role in sustaining functional and daily living disability caused by the disease. Here we to summarize the current state of the art on the involvement of central brain circuits and possibly related disabilities in patients with glaucoma.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Cesareo
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Francesco Garaci
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy; San Raffaele Cassino, Frosinone, Cassino, Italy
| | - Giacinto Bagetta
- Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, Rende, Italy
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome Tor Vergata, Rome, Italy.
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23
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Altered information flow and microstructure abnormalities of visual cortex in normal-tension glaucoma: Evidence from resting-state fMRI and DKI. Brain Res 2020; 1741:146874. [PMID: 32389589 DOI: 10.1016/j.brainres.2020.146874] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/19/2020] [Accepted: 05/03/2020] [Indexed: 11/20/2022]
Abstract
Normal tension glaucoma (NTG) is a neurodegenerative disease involves multiple brain areas, but the mechanism remains unclear. The aim of this study is to investigate the correlation between structural injury and functional reorganization in the brain of NTG, using resting-state functional MRI and diffusion kurtosis imaging (DKI) data acquired for 26 NTG patients and 24 control subjects. Granger causality analysis (GCA) was used to calculate the effective connectivity (EC) between visual cortices and the whole brain to reflect the information flow. The fractional anisotropy (FA), mean kurtosis (MK), axial kurtosis (AK), and radial kurtosis (RK) derived from DKI of visual cortices were extracted to evaluate structural injury. Microstructural abnormalities were detected in bilateral BA17, BA18, and BA19. NTG patients showed significantly decreased EC from BA17 to higher visual cortices and increase EC from higher visual cortices to BA17. The EC from BA17 to posterior cingulate cortex (PCC) and from PCC to BA17 both significantly increased, while the EC from right BA18 and BA19 to PCC significantly decreased. Decreased EC between somatosensory cortex and BA17, as well as the decreased ECs between supramarginal gyrus (SMA) and BA17/BA19 were detected. Several abnormal ECs were significantly correlated with microstructural injuries of BA17 and BA18. In conclusion, NTG causes reorganization of information flows among visual cortices and other brain areas, which is consistent with brain microstructural injury.
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24
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Deng W, Liu C, Parra C, Sims JR, Faiq MA, Sainulabdeen A, Song H, Chan KC. Quantitative imaging of the clearance systems in the eye and the brain. Quant Imaging Med Surg 2020; 10:1-14. [PMID: 31956524 DOI: 10.21037/qims.2019.11.18] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Wenyu Deng
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Crystal Liu
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Carlos Parra
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Jeffrey R Sims
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Muneeb A Faiq
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Anoop Sainulabdeen
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Hana Song
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA
| | - Kevin C Chan
- Department of Ophthalmology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA.,Department of Radiology, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA.,Neuroscience Institute, New York University (NYU) School of Medicine, NYU Langone Health, New York, NY, USA.,Center for Neural Science, Faculty of Arts and Science, New York University, New York, NY, USA
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