Structural and functional brain changes in early- and mid-stage primary open-angle glaucoma using voxel-based morphometry and functional magnetic resonance imaging

Ming-Ming Jiang, Qing Zhou, Xiao-Yong Liu, Chang-Zheng Shi, Jian Chen, Xiang-He Huang, Ming-Ming Jiang, Qing Zhou, Xiao-Yong Liu, Chang-Zheng Shi, Jian Chen, Xiang-He Huang

Abstract

To investigate structural and functional brain changes in patients with primary open-angle glaucoma (POAG) by using voxel-based morphometry based on diffeomorphic anatomical registration through exponentiated Lie algebra (VBM-DARTEL) and blood oxygenation level dependent functional magnetic resonance imaging (BOLD-fMRI), respectively.Thirteen patients diagnosed with POAG and 13 age- and sex-matched healthy controls were enrolled in the study. For each participant, high-resolution structural brain imaging and blood flow imaging were acquired on a 3.0-Tesla magnetic resonance imaging (MRI) scanner. Structural and functional changes between the POAG and control groups were analyzed. An analysis was carried out to identify correlations between structural and functional changes acquired in the previous analysis and the retinal nerve fiber layer (RNFL).Patients in the POAG group showed a significant (P < 0.001) volume increase in the midbrain, left brainstem, frontal gyrus, cerebellar vermis, left inferior parietal lobule, caudate nucleus, thalamus, precuneus, and Brodmann areas 7, 18, and 46. Moreover, significant (P < 0.001) BOLD signal changes were observed in the right supramarginal gyrus, frontal gyrus, superior frontal gyrus, left inferior parietal lobule, left cuneus, and left midcingulate area; many of these regions had high correlations with the RNFL.Patients with POAG undergo widespread and complex changes in cortical brain structure and blood flow. (ClinicalTrials.gov number: NCT02570867).

Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
A 1-sample t test of the primary open-angle glaucoma (POAG) and control groups (P < 0.05, cluster >10). Red region: high blood signal area; blue region: low blood signal area.
Figure 2
Figure 2
Areas with different structures and blood signals between the POAG and control groups shown using VBM-DARTEL and BOLD-fMRI (P < 0.001, AlphaSim corrected). The red region in the VBM image represents a larger area in the POAG group than in the control group. The red region in the BOLD image shows an area of higher signal in the POAG group than in the control group. BOLD-fMRI = blood oxygenation level-dependent functional magnetic resonance imaging, POAG = primary open-angle glaucoma, VBM-DARTEL = voxel-based morphometry based on diffeomorphic anatomical registration through exponentiated Lie.
Figure 3
Figure 3
Correlation analysis results from VBM-RNFL and BOLD-RNFL analyses. T-score bars are shown on the right. Red region: positively correlated area; blue region: negatively correlated area. BOLD = blood oxygenation level, RNFL = retinal nerve fiber layer, VBM = voxel-based morphometry.

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