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Loskutova E, Butler JS, Setti A, O'Brien C, Loughman J. Ability to Process Multisensory Information Is Impaired in Open Angle Glaucoma. J Glaucoma 2024; 33:78-86. [PMID: 37974328 DOI: 10.1097/ijg.0000000000002331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
PRCIS Patients with glaucoma demonstrated deficiencies in their ability to process multisensory information when compared with controls, with those deficiencies being related to glaucoma severity. Impaired multisensory integration (MSI) may affect the quality of life in individuals with glaucoma and may contribute to the increased prevalence of falls and driving safety concerns. Therapeutic possibilities to influence cognition in glaucoma should be explored. PURPOSE Glaucoma is a neurodegenerative disease of the optic nerve that has also been linked to cognitive health decline. This study explored MSI as a function of glaucoma status and severity. METHODS MSI was assessed in 37 participants with open angle glaucoma relative to 18 age-matched healthy controls. The sound-induced flash illusion was used to assess MSI efficiency. Participants were presented with various combinations of simultaneous visual and/or auditory stimuli and were required to indicate the number of visual stimuli observed for each of the 96 total presentations. Central retinal sensitivity was assessed as an indicator of glaucoma severity (MAIA; CenterVue). RESULTS Participants with glaucoma performed with equivalent capacity to healthy controls on unisensory trials ( F1,53 =2.222, P =0.142). Both groups performed equivalently on congruent multisensory trials involving equal numbers of auditory and visual stimuli F1,53 =1.032, P =0.314). For incongruent presentations, that is, 2 beeps and 1 flash stimulus, individuals with glaucoma demonstrated a greater influence of the incongruent beeps when judging the number of flashes, indicating less efficient MSI relative to age-matched controls ( F1,53 =11.45, P <0.002). In addition, MSI performance was positively correlated with retinal sensitivity ( F3,49 =4.042, P <0.025), adjusted R ²=0.15). CONCLUSIONS Individuals with open angle glaucoma exhibited MSI deficiencies that relate to disease severity. The type of deficiencies observed were similar to those observed among older individuals with cognitive impairment and balance issues. Impaired MSI may, therefore, be relevant to the increased prevalence of falls observed among individuals with glaucoma, a concept that merits further investigation.
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Affiliation(s)
- Ekaterina Loskutova
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
| | - John S Butler
- Centre for Eye Research Ireland, School of Mathematical Sciences, Technological University Dublin, Dublin, Ireland
| | - Annalisa Setti
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Colm O'Brien
- Department of Ophthalmology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - James Loughman
- Centre for Eye Research Ireland, School of Physics, Clinical & Optometric Sciences, Technological University Dublin, Dublin, Ireland
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2
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Wang H, Yan X, Zhang Q, Wu Q, Qiu L, Zhou J, Guo P. Altered small-world and disrupted topological properties of functional connectivity networks in patients with nonarteritic anterior ischemic optic neuropathy. Clin Neurol Neurosurg 2024; 236:108101. [PMID: 38176218 DOI: 10.1016/j.clineuro.2023.108101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/22/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Nonarteritic anterior ischemic optic neuropathy (NAION) is a disease of the optic nerve, but its effect on brain network topology is still unclear.This study aimed to investigate brain network alterations in NAION patients and to explore their relationship with functional impairment. METHODS Resting-state functional MRI data were collected from 23 NAION patients and 23 matched healthy control subjects.We used graph theory analysis to investigate the global and nodal network topological properties,and network-based statistical (NBS) methods were used to explore intergroup differences in functional connectivity (FC) strength. RESULTS Compared to the control group, NAION patients had lower global efficiency, normalized clustering coefficient and small-world values and higher characteristic path length (P < 0.05). In the hub distributions of functional networks, the NAION group had one hub region disappearing and four hub regions appearing in nodal degree centrality (Dc), and two hubs disappearing and one hub region appearing in nodal betweenness centrality (Bc). The NAION group also had enhanced brain FC primarily associated with the frontal, prefrontal, parietal lobes and cerebellum. Furthermore, the right temporal pole, superior temporal gyrus (r = -0.424), the right inferior temporal gyrus (r = -0.414), the right cerebellar lobule Ⅵ (r = 0.450), and the left cerebellar lobule crus Ⅰ (r = 0.584) were significantly correlated with clinical severity. CONCLUSION NAION patients show disruption and redistribution of FC in specific regions of the brain network, which may be associated with visual impairment.
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Affiliation(s)
- Hui Wang
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China
| | - Xiaoling Yan
- Department of Ophthalmology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Qiuhuan Zhang
- Department of Radiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China
| | - Qiong Wu
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China
| | - Lixin Qiu
- Department of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University; Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing 100730, China
| | - Jian Zhou
- Department of Ophthalmology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China.
| | - Pengde Guo
- Department of Radiology, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China.
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3
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Martucci A, Di Giuliano F, Minosse S, Pocobelli G, Nucci C, Garaci F. MRI and Clinical Biomarkers Overlap between Glaucoma and Alzheimer's Disease. Int J Mol Sci 2023; 24:14932. [PMID: 37834380 PMCID: PMC10573932 DOI: 10.3390/ijms241914932] [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: 09/04/2023] [Accepted: 09/22/2023] [Indexed: 10/15/2023] Open
Abstract
Glaucoma is the leading cause of blindness worldwide. It is classically associated with structural and functional changes in the optic nerve head and retinal nerve fiber layer, but the damage is not limited to the eye. The involvement of the central visual pathways and disruption of brain network organization have been reported using advanced neuroimaging techniques. The brain structural changes at the level of the areas implied in processing visual information could justify the discrepancy between signs and symptoms and underlie the analogy of this disease with neurodegenerative dementias, such as Alzheimer's disease, and with the complex group of pathologies commonly referred to as "disconnection syndromes." This review aims to summarize the current state of the art on the use of advanced neuroimaging techniques in glaucoma and Alzheimer's disease, highlighting the emerging biomarkers shared by both diseases.
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Affiliation(s)
- Alessio Martucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy;
| | - Silvia Minosse
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; (S.M.); (F.G.)
| | - Giulio Pocobelli
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Carlo Nucci
- Ophthalmology Unit, Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; (A.M.); (G.P.)
| | - Francesco Garaci
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, 00133 Rome, Italy; (S.M.); (F.G.)
- San Raffaele Cassino, 03043 Frosinone, Italy
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4
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Wang Y, Chen L, Cai F, Gao J, Ouyang F, Chen Y, Yin M, Hua C, Zeng X. Altered functional connectivity of the thalamus in primary angle-closure glaucoma patients: A resting-state fMRI study. Front Neurol 2022; 13:1015758. [PMID: 36277918 PMCID: PMC9583913 DOI: 10.3389/fneur.2022.1015758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/20/2022] [Indexed: 12/03/2022] Open
Abstract
Background and objectives Glaucoma is one of the leading irreversible causes of blindness worldwide, and previous studies have shown that there is abnormal functional connectivity (FC) in the visual cortex of glaucoma patients. The thalamus is a relay nucleus for visual signals; however, it is not yet clear how the FC of the thalamus is altered in glaucoma. This study investigated the alterations in thalamic FC in patients with primary angle-closure glaucoma (PACG) by using resting-state functional MRI (rs-fMRI). We hypothesized that PACG patients have abnormal FC between the thalamus and visual as well as extravisual brain regions. Methods Clinically confirmed PACG patients and age- and gender-matched healthy controls (HCs) were evaluated by T1 anatomical and functional MRI on a 3 T scanner. Thirty-four PACG patients and 33 HCs were included in the rs-fMRI analysis. All PACG patients underwent complete ophthalmological examinations; included retinal nerve fiber layer thickness (RNFLT), intraocular pressure (IOP), average cup-to-disc ratio (A-C/D), and vertical cup-to-disc ratio (V-C/D). After the MRI data were preprocessed, the bilateral thalamus was chosen as the seed point; and the differences in resting-state FC between groups were evaluated. The brain regions that significantly differed between PACG patients and HCs were identified, and the correlations were then evaluated between the FC coefficients of these regions and clinical variables. Results Compared with the HCs, the PACG patients showed decreased FC between the bilateral thalamus and right transverse temporal gyrus, between the bilateral thalamus and left anterior cingulate cortex, and between the left thalamus and left insula. Concurrently, increased FC was found between the bilateral thalamus and left superior frontal gyrus in PACG patients. The FC between the bilateral thalamus and left superior frontal gyrus was positively correlated with RNFLT and negatively correlated with the A-C/D and V-C/D. The FC between the left thalamus and left insula was negatively correlated with IOP. Conclusion Extensive abnormal resting-state functional connections between the thalamus and visual and extravisual brain areas were found in PACG patients, and there were certain correlations with clinical variables, suggesting that abnormal thalamic FC plays an important role in the progression of PACG.
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Affiliation(s)
- Yuanyuan Wang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Linglong Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Fengqin Cai
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Junwei Gao
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ouyang
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ye Chen
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mingxue Yin
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Chengpeng Hua
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xianjun Zeng
- Department of Radiology, The First Affiliated Hospital of Nanchang University, Nanchang, China
- *Correspondence: Xianjun Zeng
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Kang L, Wan C. Application of advanced magnetic resonance imaging in glaucoma: a narrative review. Quant Imaging Med Surg 2022; 12:2106-2128. [PMID: 35284278 PMCID: PMC8899967 DOI: 10.21037/qims-21-790] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 11/26/2021] [Indexed: 04/02/2024]
Abstract
Glaucoma is a group of eye diseases characterized by progressive degeneration of the optic nerve head and retinal ganglion cells and corresponding visual field defects. In recent years, mounting evidence has shown that glaucoma-related damage may not be limited to the degeneration of retinal ganglion cells or the optic nerve head. The entire structure of the visual pathway may be degraded, and the degradation may even extend to some non-visual brain regions. We know that advanced morphological, functional, and metabolic magnetic resonance technologies provide a means to observe quantitatively and in real time the state of brain function. Advanced magnetic resonance imaging (MRI) techniques provide additional diagnostic markers for glaucoma, which are related to known potential histopathological changes. Many researchers in China and globally have conducted clinical and imaging studies on glaucoma. However, they are scattered, and we still need to systematically sort out the advanced MRI related to glaucoma. We reviewed literature published in any language and included all studies that were able to be translated into English from 1 January 1980 to 31 July 2021. Our literature search focused on emerging magnetic resonance neuroimaging techniques for the study of glaucoma. We then identified each functional area of the brain of glaucoma patients through the integration of anatomy, image, and function. The aim was to provide more information about the occurrence and development of glaucoma diseases. From the perspective of neuroimaging, our study provides a research basis to explain the possible mechanism of the occurrence and development of glaucoma. This knowledge gained from these techniques enables us to more clearly observe the damage glaucoma causes to the whole visual pathway. Our study provides new insights into glaucoma-induced changes to the brain. Our findings may enable the progress of these changes to be analyzed and inspire new neuroprotective therapeutic strategies for patients with glaucoma in the future.
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Affiliation(s)
- Longdan Kang
- Department of Ophthalmology, the First Hospital of China Medical University, Shenyang, China
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Ding J, Qu X, Cui J, Dong J, Guo J, Xian J, Li D. Altered Spontaneous Brain Activity and Network Property in Patients With Congenital Monocular Blindness. Front Neurol 2022; 13:789655. [PMID: 35280267 PMCID: PMC8907119 DOI: 10.3389/fneur.2022.789655] [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: 10/05/2021] [Accepted: 01/25/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with congenital monocular blindness may have specific brain changes since the brain is prenatally deprived of half the normal visual input. To explore characteristic brain functional changes of congenital monocular blindness, we analyzed resting-state functional MRI (rs-fMRI) data of 16 patients with unilateral congenital microphthalmia and 16 healthy subjects with normal vision to compare intergroup differences of amplitude of low frequency fluctuations (ALFFs), functional connectivity (FC), and network topolgoical properties. Compared with controls, patients with microphthalmia exhibited significantly lower ALFF values in the left inferior occipital and temporal gyri, superior temporal gyrus, inferior parietal lobe and post-central gyrus, whereas higher ALFF in the right middle and inferior temporal gyri, middle and superior frontal gyri, left superior frontal, and temporal gyri, such as angular gyrus. Meanwhile, FC between left medial superior frontal gyrus and angular gyrus, FC between left superior temporal gyrus and inferior parietal lobe and post-central gyrus decreased in the patients with congenital microphthalmia. In addition, a graph theory-analysis revealed increased regional network metrics (degree centrality and nodal efficiency) in the middle and inferior temporal gyri and middle and superior frontal gyri, while decreased values in the inferior occipital and temporal gyri, inferior parietal lobule, post-central gyrus, and angular gyrus. Taken together, patients with congenital microphthalmia had widespread abnormal activities within neural networks involving the vision and language and language-related regions played dominant roles in their brain networks. These findings may provide clues for functional reorganization of vision and language networks induced by the congenital monocular blindness.
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Affiliation(s)
- Jingwen Ding
- Beijing Ophthalmology & Visual Science Key Lab, Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Xiaoxia Qu
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jing Cui
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jie Dong
- Beijing Ophthalmology & Visual Science Key Lab, Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Jian Guo
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Junfang Xian
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- *Correspondence: Junfang Xian
| | - Dongmei Li
- Beijing Ophthalmology & Visual Science Key Lab, Department of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
- Dongmei Li
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7
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Imaging biomarkers for Alzheimer's disease and glaucoma: Current and future practices. Curr Opin Pharmacol 2022; 62:137-144. [PMID: 34995895 DOI: 10.1016/j.coph.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/06/2021] [Accepted: 12/06/2021] [Indexed: 11/22/2022]
Abstract
Glaucoma is a leading cause of blindness worldwide. Although intraocular pressure is the main risk factor for glaucoma, several intraocular pressure independent factors have been associated with the risk of developing the disease and its progression. The diagnosis of glaucoma relies on clinical features of the optic nerve, visual field test, and optical coherence tomography. However, the multidisciplinary aspect of the disease suggests that other biomarkers may be useful for the diagnosis, thus underling the importance of novel imaging techniques supporting clinicians. This review analyzes the common pathogenic mechanisms between glaucoma and Alzheimer's disease and the possible novel approaches for diagnosis and follow up.
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8
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Minosse S, Garaci F, Martino F, Di Mauro R, Melis M, Di Giuliano F, Picchi E, Guerrisi M, Floris R, Di Girolamo S, Toschi N. Global and local brain connectivity changes associated with sudden unilateral sensorineural hearing loss. NMR IN BIOMEDICINE 2021; 34:e4544. [PMID: 34046962 DOI: 10.1002/nbm.4544] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 04/28/2021] [Accepted: 04/28/2021] [Indexed: 06/12/2023]
Abstract
Recent studies suggest that even moderate sudden sensorineural hearing loss (SSNHL) causes reduction of gray matter volume in the primary auditory cortex, diminishing its ability to react to sound stimulation, as well as reorganization of functional brain networks. We employed resting-state functional MRI (rs-fMRI), in conjunction with graph-theoretical analysis and a newly developed functional "disruption index," to study whole-brain as well as local functional changes in patients with unilateral SSNHL. We also assessed the potential of graph-theoretical measures as biomarkers of disease, in terms of their relationship to clinically relevant audiological parameters. Eight patients with moderate or severe unilateral SSNHL and 15 healthy controls were included in this prospective pilot study. All patients underwent rs-fMRI to study potential changes in brain connectivity. From rs-fMRI data, global and local graph-theoretical measures, disruption index, and audiological examinations were estimated. Mann-Whitney U tests were used to study the differences between SSNHL patients and healthy controls. Associations between brain metrics and clinical variables were studied using multiple linear regressions, and the presence or absence of brain network hubs was assessed using Fisher's exact test. No statistically significant differences between SSNHL patients and healthy controls were found in global or local network measures. However, when analyzing brain networks through the disruption index, we found a brain-wide functional network reorganization (p < 0.001 as compared with controls), whose extent was associated with clinical impairment (p < 0.05). We also observed several functional hubs in SSNHL patients that were not present in healthy controls and vice versa. Our results demonstrate a brain involvement in SSNHL patients, not detectable using conventional graph-theoretical analysis, which may yield subtle disease clues and possibly aid in monitoring disease progression in clinical trials.
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Affiliation(s)
- Silvia Minosse
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
- San Raffaele Cassino, Cassino, Frosinone, Italy
| | - Federica Martino
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Roberta Di Mauro
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
- Neuroscience Unit, Department of Systems Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Milena Melis
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Eliseo Picchi
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Stefano Di Girolamo
- Otorhinolaryngology Unit, Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
- Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts
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Di Giuliano F, Minosse S, Picchi E, Ferrazzoli V, Da Ros V, Muto M, Pistolese CA, Garaci F, Floris R. Qualitative and quantitative analysis of 3D T1 Silent imaging. Radiol Med 2021; 126:1207-1215. [PMID: 34131844 DOI: 10.1007/s11547-021-01380-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 05/20/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To compare brain magnetic resonance imaging (MRI) using T1 3D Silent and fast T1 3D Gradient-Echo (GRE) BRAin VOlume (known as BRAVO) sequences. The primary aim is to assess the quantitative and qualitative analysis of Silent and BRAVO images by the measurement of the contrast (C), the signal-to-noise ratio (SNR) and the contrast-to-noise ratio (CNR). The second aim is to estimate the subjective sound levels and the specific absorption rate (SAR). METHODS Twenty-two subjects had T1 3D Silent and T1 3D BRAVO sequences added to the standard MR examination. The qualitative analysis of the two sequences was performed by two radiologists independently. The quantitative analysis was performed by placing regions of interest on the cerebrospinal fluid, on the white and grey matter. The C, the CNR and the SNR were calculated for each sequence. After each T1-3D sequence, subjects gave a score rating to evaluate the acoustic noise. Finally, the SAR was evaluated by the digital imaging and communications in medicine (DICOM) tags. RESULTS The image quality scores obtained by the two radiologists were higher for BRAVO compared to the Silent. However, qualitatively, the Silent images were similar to BRAVO for diagnostic use. Quantitatively, CNR for GM-CSF was comparable in the two sequences and SNR in CSF was higher in Silent than BRAVO. The acoustic noise of Silent sequence was statistically lower compared with BRAVO. The maximum SAR measured was 1.4 W/kg. CONCLUSIONS 3D T1 Silent can be a valid alternative technique to conventional BRAVO to reduce the acoustic noise preserving the diagnostic accuracy. However, radiologists preferred the conventional sequence to Silent.
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Affiliation(s)
- Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Silvia Minosse
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy.
| | - Eliseo Picchi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Valentina Ferrazzoli
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Valerio Da Ros
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
| | - Massimo Muto
- Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80100, Naples, Italy
| | - Chiara Adriana Pistolese
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Viale Oxford 81, 00133, Rome, Italy
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- San Raffaele Cassino, Cassino, Italy
| | - Roberto Floris
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Via Montpellier 1, Viale Oxford 81, 00133, Rome, Italy
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Viale Oxford 81, 00133, Rome, Italy
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10
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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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11
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Minosse S, Picchi E, Di Giuliano F, Sarmati L, Teti E, Pistolese CA, Lanzafame S, Di Ciò F, Guerrisi M, Andreoni M, Floris R, Toschi N, Garaci F. Functional brain network reorganization in HIV infection. J Neuroimaging 2021; 31:796-808. [PMID: 33900655 DOI: 10.1111/jon.12861] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/15/2021] [Accepted: 03/15/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND PURPOSE To investigate the reorganization of the central nervous system provided by resting state-functional MRI (rs-fMRI), graph-theoretical analysis, and a newly developed functional brain network disruption index in patients with human immunodeficiency virus (HIV) infection. METHODS Forty HIV-positive patients without neurological impairment and 20 age- and sex-matched healthy controls underwent rs-fMRI at 3T; blood sampling was obtained the same day to evaluate biochemical variables (absolute, relative, and nadir CD4 T-lymphocytes value and plasmatic HIV-RNA). From fMRI data, disruption indices, as well as global and local graph theoretical measures, were estimated and examined for group differences (HIV vs. controls) as well as for associations with biochemical variables (HIV only). Finally, all data (global and local graph-theoretical measures, disruption indices, and biochemical variables) were tested for putative differences across three patient groups based on the duration of combined antiretroviral therapy (cART). RESULTS Brain function of HIV patients appeared to be deeply reorganized as compared to normal controls. The disruption index showed significant negative association with relative CD4 values, and a positive significant association between plasmatic HIV-RNA and local graph-theoretical metrics in the left lingual gyrus and the right lobule IV and V of right cerebellar hemisphere was also observed. Finally, a differential distribution of HIV clinical biomarkers and several brain metrics was observed across cART duration groups. CONCLUSION Our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early and subtle functional changes of brain networks in HIV patients.
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Affiliation(s)
- Silvia Minosse
- 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
| | - Francesca Di Giuliano
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Loredana Sarmati
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Elisabetta Teti
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Chiara Adriana Pistolese
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Simona Lanzafame
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Francesco Di Ciò
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Maria Guerrisi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Massimo Andreoni
- Clinical Infectious Diseases, Tor Vergata University, Rome, Italy
| | - Roberto Floris
- Diagnostic Imaging Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Nicola Toschi
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,Athinoula A. Martinos Center for Biomedical Imaging, Harvard Medical School, Boston, Massachusetts, USA
| | - Francesco Garaci
- Neuroradiology Unit, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.,San Raffaele Cassino, Frosinone, Italy
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12
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Wu Q, Hu H, Chen W, Chen HH, Chen L, Zhou J, Liu H, Wu FY, Xu XQ. Disrupted Topological Organization of the Brain Structural Network in Patients With Thyroid-Associated Ophthalmopathy. Invest Ophthalmol Vis Sci 2021; 62:5. [PMID: 33821882 PMCID: PMC8039468 DOI: 10.1167/iovs.62.4.5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Purpose Increasing evidence indicated that thyroid-associated ophthalmopathy (TAO) might be a neural related disease more than an ocular disease. In this study, we aimed to investigate the alterations of structural brain connectome in patients with TAO. Methods Twenty-seven patients with TAO and 27 well-matched healthy controls underwent diffusion tensor imaging. Graph theoretical analyses, including global (shortest path length, clustering coefficient, small-worldness, global efficiency, and local efficiency) and nodal (nodal betweenness, nodal degree, and nodal efficiency) topological properties and network-based statistics were performed to evaluate TAO-related changes in brain network pattern. Correlations were assessed between the network properties and clinical variables, including disease duration, visual acuity, neuropsychiatric measurements, and serum thyroid function indexes. Results Compared with healthy controls, patients with TAO exhibited preserved global network parameters but altered nodal properties. We found decreased nodal betweenness and nodal degree in right anterior cingulate and paracingulate gyri, decreased nodal degree and nodal efficiency in the right orbital part of middle frontal gyrus (ORBmid), whereas increased nodal degree and nodal efficiency in the left cuneus. Decrease of structural connectivity strength was found involving the right ORBmid, right putamen, left caudate nucleus, and left medial superior frontal gyrus. Significant correlations were also found between nodal properties and neuropsychological performances as well as visual acuity. Conclusions Patients with TAO developed disruption of structural brain network connectome. Disrupted topological organization of the brain structural network may be associated with the clinical-psychiatric dysfunction of patients with TAO.
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Affiliation(s)
- Qian Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hao Hu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Wen Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Huan-Huan Chen
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Lu Chen
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Jiang Zhou
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Hu Liu
- Department of Ophthalmology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Fei-Yun Wu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xiao-Quan Xu
- Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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13
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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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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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15
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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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16
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Cio FD, Garaci F, Minosse S, Passamonti L, Martucci A, Lanzafame S, Giuliano FD, Picchi E, Mancino R, Guerrisi M, Nucci C, Floris R, Toschi N. Disruption of structural brain networks in Primary Open Angle Glaucoma. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1705-1708. [PMID: 33018325 DOI: 10.1109/embc44109.2020.9175417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Primary open angle glaucoma (POAG) is one of the most common causes of permanent blindness in the world. Recent studies have originated the hypothesis that POAG could be considered as a central nervous system pathology which results in secondary visual involvement. The aim of this study is to assess possible structural whole brain connectivity alterations in POAG by combining multi-shell diffusion weighted imaging, multi-shell multi-tissue probabilistic tractography, graph theoretical measures and a newly designed disruption index, which evaluates the global reorganization of brain networks in group-wise comparisons. We found global differences in structural connectivity between Glaucoma patients and controls, as well as in local graph theoretical measures. These changes extended well beyond the primary visual pathway. Furthermore, group-wise and subject-wise disruption indices were found to be statistically different between glaucoma patients and controls, with a positive slope. Overall, our results support the hypothesis of a whole-brain structural reorganization in glaucoma which is specific to structural connectivity, possibly placing this disease within the recently defined groups of brain disconnection syndrome.
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17
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Minosse S, Picchi E, Giuliano FD, Lanzafame S, Manenti G, Pistolese CA, Sarmati L, Teti E, Andreoni M, Floris R, Guerrisi M, Garaci F, Toschi N. Disruption of brain network organization in patients with human immunodeficiency virus (HIV) infection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1726-1729. [PMID: 33018330 DOI: 10.1109/embc44109.2020.9176449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
In 2019, approximately 38 million people were living with human immunodeficiency virus (HIV). Combined antiretroviral therapy (cART) has determined a change in the course of HIV infection, transforming it into a chronic condition which results in cumulative exposure to antiretroviral drugs, inflammatory effects and aging. Relatedly, at least one quarter of HIV-infected patients suffer from cognitive, motor and behavioral disorder, globally known as HIV-associated neurocognitive disorders (HAND). In this context, objective, neuroimaging-based biomarkers are therefore highly desirable in order to detect, quantify and monitor HAND in all disease stages. In this study, we employed functional MRI in conjunction with graph-theoretical analysis as well as a newly developed functional brain network disruption index to assess a putative functional reorganization in HIV positive patients. We found that brain function of HIV patients is deeply reorganized as compared to normal controls. Interestingly, the regions in which we found reorganized hubs are integrated into neuronal networks involved in working memory, motor and executive functions often altered in patients with HAND. Overall, our study demonstrates that rs-fMRI combined with advanced graph theoretical analysis and disruption indices is able to detect early, subtle functional changes of brain networks in HIV patients before structural changes become evident.
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18
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Minosse S, Garaci F, Martino F, Mauro RD, Melis M, Giuliano FD, Picchi E, Floris R, Guerrisi M, Girolamo SD, Toschi N. Global and local reorganization of brain network connectivity in sudden sensorineural hearing loss. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:1730-1733. [PMID: 33018331 DOI: 10.1109/embc44109.2020.9175688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Recent reports suggested that even moderate sudden sensorineural hearing loss (SSNHL) can be partly responsible for a loss of gray matter volume in the primary auditory cortex, hence reducing the capacity of the auditory cortical areas to react to sound stimulation. There is also evidence for a plastic reorganization of brain functional networks visible as enhanced local functional connectivity. The aim of this study was to use rs-fMRI, in conjunction with graph- theoretical analysis and a newly developed functional "disruption index" to study whole-brain as well as local functional changes in patients with acute and unilateral sensorineural hearing loss. No statistically significant differences in global or local network measures we found between SSNHL patients and healthy controls. However, when analyzing local metrics through the disruption index k, we found negative values for k which were statistically different from zero both in single subject analysis. Additionally, we found several associations between graph-theoretical metrics and clinical parameters.
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19
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Conti A, Akeju O, Duggento A, Chamadia S, Barbieri R, Toschi N. Frequency dependent functional brain reorganization in anesthesia is specific to drug concentration. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:2921-2924. [PMID: 33018618 DOI: 10.1109/embc44109.2020.9176406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The differential effects of general anesthesia on brain activity in terms of drug selection, concentration and combination remain to be elucidated. Using fMRI, it has been shown that increasing doses of sevoflurane is associated with progressive breakdown in brain functional connectivity, while EEG studies have shown that higher activity in the delta band is associated with unconsciousness. Despite these promising results, the band- specific neural substrates of brain changes which occur during sevoflurane anesthesia have not yet been investigated. To this end, we employ high-density EEG-based brain connectivity estimates and graph theoretical analysis in a protocol of progressive sevoflurane administration (conditions: baseline, 1.1%, 2.1%, 2.8%, recovery), both at a global (whole-brain) and at a local (sensor-specific) level in 12 healthy subjects (7 males, mean age 25 ± 4.7 years). We show a statistically significant dependence of global strength, clustering coefficient and efficiency on sevoflurane concentration in the slow delta, beta 1 and beta 2 bands. Interestingly, high and low-frequency bands behaved in an opposite manner as a function of condition. We also found significant band*condition interactive effects in clustering coefficient, efficiency and strength both on local and global scales.
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Abstract
The damage caused by glaucoma has been extensively evaluated at the level of the retina and optic nerve head. Many advances have been shown in this field in the last decades. Recent studies have also proved degenerative changes in the brain involving the intracranial optic nerve, lateral geniculate nucleus, and visual cortex. Moreover, these brain abnormalities are also correlated with clinical, optic nerve head, and visual field findings. In this review, we critically evaluate the existing literature studying the use of magnetic resonance imaging in glaucoma, and we discuss issues related to how magnetic resonance imaging results should be incorporated into our clinical practice.
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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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Wang B, Yan T, Zhou J, Xie Y, Qiu J, Wang Y, Lu W. Altered fMRI-derived functional connectivity in patients with high-tension glaucoma. J Neuroradiol 2020; 48:94-98. [PMID: 32169470 DOI: 10.1016/j.neurad.2020.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 02/17/2020] [Accepted: 03/02/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND High-tension glaucoma (HTG) is associated with functional changes in the brain, and elevated intraocular pressure (IOP) is one of the major causes. PURPOSE To evaluate the effects of high IOP on the brain in patients with HTG by using resting-state functional magnetic resonance imaging (rs-fMRI). MATERIALS AND METHODS Thirty-six patients with HTG and 20 age- and gender-matched healthy controls (HCs) were recruited and underwent IOP examination and rs-fMRI scan. Voxel-wise functional connectivity (FC) values were obtained between the Brodmann Area (BA) 17 (primary visual cortex) and the rest of the brain, two-sample t test was performed between HTG group and HCs. Correlation analysis was performed between FC and clinical information. RESULTS Compared with HCs, HTG patients demonstrated decreased FC between BA 17 and the right precuneus gyrus, decreased FC between BA 17 and the right superior frontal gyrus (SFG) (GRF corrected at voxel level P<0.001 and cluster level P<0.05, two-tailed). FC between BA 17 and the right SFG showed significantly negative correlation with right eyes' IOP and mean IOP. CONCLUSION HTG patients had abnormal FC changes between the visual cortex and multiple functional brain regions related to visual sense, memory consolidation and cognitive processing, which provided image support for the pathophysiology research of HTG, and revealed new targets for the accurate treatment of HTG.
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Affiliation(s)
- Baojian Wang
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
| | - Tingqin Yan
- Department of Ophthalmology, Taian City Central Hospital, Taian, China
| | - Jian Zhou
- Department of Radiology, Taian City Central Hospital, Taian, China
| | - Yuanzhong Xie
- Department of Radiology, Taian City Central Hospital, Taian, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China; Medical Engineering and Technology Research Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
| | - Yi Wang
- Department of Ophthalmology, The Second Affiliated hospital of Shandong First Medical University, Taian, China.
| | - Weizhao Lu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China; Medical Engineering and Technology Research Center, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China.
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