Oculomotor

眼动
  • 文章类型: Journal Article
    背景:在注意缺陷/多动障碍(ADHD)中,抑制性控制不良是其主要特征之一,眼球运动抑制受损被认为是该疾病的潜在生物标志物。虽然听觉白噪声已经证明了在这个群体中增强工作记忆的能力,视觉白噪声仍未被探索,两种类型的白噪声刺激对动眼抑制的影响也是如此。
    目的:这项交叉研究旨在探讨听觉和视觉白噪声对ADHD儿童和典型发育(TD)儿童动眼抑制的影响。该研究将调查不同噪声水平的影响(25%和50%的视觉,78dB听觉),和性能将在有和没有噪声刺激的情况下进行评估。我们假设暴露于白噪声会改善多动症儿童的表现,并损害TD儿童的表现。
    方法:记忆引导扫视和长时间注视,以检测ADHD中动眼神经抑制的敏感性而闻名,将用于评估性能。被诊断患有多动症的儿童,停药24小时,并招募了没有精神疾病的TD儿童进行研究。
    结果:数据收集于2023年10月启动,并于2024年2月结束。共有97名参与者报名参加,第一个结果预计在2024年9月至11月之间。
    结论:这项研究将检查跨模态感觉刺激是否可以增强执行功能,特别是眼球运动控制,患有ADHD的儿童。此外,这项研究将探讨两组听觉和视觉噪声效应之间的潜在差异。我们的目标是确定理解如何使用噪声来提高认知能力的含义。
    背景:ClinicalTrials.govNCT06057441;https://clinicaltrials.gov/study/NCT06057441。
    DERR1-10.2196/56388。
    BACKGROUND: In attention-deficit/hyperactivity disorder (ADHD), poor inhibitory control is one of the main characteristics, with oculomotor inhibition impairments being considered a potential biomarker of the disorder. While auditory white noise has demonstrated the ability to enhance working memory in this group, visual white noise is still unexplored and so are the effects of both types of white noise stimulation on oculomotor inhibition.
    OBJECTIVE: This crossover study aims to explore the impact of auditory and visual white noise on oculomotor inhibition in children with ADHD and typically developing (TD) children. The study will investigate the impact of different noise levels (25% and 50% visual, 78 dB auditory), and performance will be evaluated both with and without noise stimulation. We hypothesize that exposure to white noise will improve performance in children with ADHD and impair the performance for TD children.
    METHODS: Memory-guided saccades and prolonged fixations, known for their sensitivity in detecting oculomotor disinhibition in ADHD, will be used to assess performance. Children diagnosed with ADHD, withdrawing from medication for 24 hours, and TD children without psychiatric disorders were recruited for the study.
    RESULTS: Data collection was initiated in October 2023 and ended in February 2024. A total of 97 participants were enrolled, and the first results are expected between September and November 2024.
    CONCLUSIONS: This study will examine whether cross-modal sensory stimulation can enhance executive function, specifically eye movement control, in children with ADHD. In addition, the study will explore potential differences between auditory and visual noise effects in both groups. Our goal is to identify implications for understanding how noise can be used to improve cognitive performance.
    BACKGROUND: ClinicalTrials.gov NCT06057441; https://clinicaltrials.gov/study/NCT06057441.
    UNASSIGNED: DERR1-10.2196/56388.
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  • 文章类型: Journal Article
    这项研究的目的是调查奥运水平接触和非接触运动参与者的动眼功能差异。总的来说,67名男女奥林匹克级接触(n=27)和非接触(n=40)运动员完成了动眼任务,包括水平扫视(HS),圆形平滑追踪(CSP),水平平滑追踪(HSP),和使用远程眼睛跟踪器的垂直平滑追踪(VSP)。性别或年龄没有显着差异。除VSP路径差异和CSP同步外,每个变量均显示与非接触运动员的接触得分更高(p<.05)。进行逻辑回归以确定HS测量的程度,CSP同步,VSP通路预测运动类型。该模型意义重大,χ2(6)=37.08,p<.001,解释了57.4%的差异,正确分类了88.1%的病例。敏感性为87.5%,特异性为88.9%。CSP同步并没有增加参加接触运动的可能性。这是第一项研究,以确定接触和非接触运动的奥运运动员之间的动眼差异,这增加了越来越多的证据表明动眼功能可能是可靠的,快,实时工具,以帮助检测运动中的mTBI。
    The purpose of this study was to investigate the difference in oculomotor functioning between Olympic-level contact and non-contact sports participants. In total, 67 male and female Olympic-level contact (n = 27) and non-contact (n = 40) athletes completed oculomotor tasks, including Horizontal Saccade (HS), Circular Smooth Pursuit (CSP), Horizontal Smooth Pursuit (HSP), and Vertical Smooth Pursuit (VSP) using a remote eye tracker. No significant differences for sex or age occurred. Each variable indicated higher scores for contact compared to non-contact athletes (p < .05) except for VSP Pathway differences and CSP Synchronization. A logistic regression was performed to determine the degree that HS measures, CSP synchronization, and VSP pathway predicted sport type. The model was significant, χ2(6) = 37.08, p < .001, explaining 57.4% of the variance and correctly classified 88.1% of cases. The sensitivity was 87.5% and specificity was 88.9%. CSP synchronization did not increase the likelihood of participating in a contact sport. This was the first study to identify oculomotor differences between Olympic athletes of contact and non-contact sports, which adds to the growing evidence that oculomotor functioning may be a reliable, quick, real-time tool to help detect mTBI in sport.
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  • 文章类型: Journal Article
    成人发育协调障碍(DCD),有时被称为运动障碍,在电机开发和协调方面遇到困难,影响他们日常生活的方方面面。令人惊讶的是,人们对他们在运动领域遇到的困难背后的机制知之甚少。在儿童DCD中,已显示眼球运动控制方面发生了变化。这项研究的目的是确定有和没有可能的DCD的成年人是否存在动眼差异。视觉固定稳定性,顺利的追求,我们在21名可能患有DCD/行为障碍(pDCD)的成人(平均年龄29岁)和21名典型发育(TD)成人(平均年龄21岁)中评估了前视和抗扫视表现.眼动追踪技术显示,前视和后视任务中的动眼反应准备在各组之间具有可比性,在两个平稳的追求任务中较慢的追求收益也是如此。然而,与没有DCD的成年人相比,患有pDCD的成年人从固定目标处进行的扫视明显更多,并且反扫视错误明显更多。Further,与TD成年人相比,患有pDCD的成年人在维持参与方面表现出困难,并且在较快的追求任务中追求增益较低。这表明患有pDCD的成年人具有扫视抑制和保持对视觉目标的注意力的问题。由于在患有DCD的儿童中也报道了这种结果模式,对于患有DCD的患者,眼球运动困难可能在整个生命周期中持续存在。意识到非典型动眼控制在整个生命周期的日常生活活动中的影响将有助于更清楚地了解DCD患者这些困难的原因和影响。
    Adults with Developmental Coordination Disorder (DCD), sometimes referred to as dyspraxia, experience difficulties in motor development and coordination, which impacts on all aspects of their daily lives. Surprisingly little is known about the mechanisms underlying the difficulties they experience in the motor domain. In childhood DCD, aspects of oculomotor control have been shown to be altered. The purpose of this study was to determine whether oculomotor differences are present in adults with and without probable DCD. Visual fixation stability, smooth pursuit, and pro-and anti-saccade performance were assessed in 21 adults (mean age 29 years) with probable DCD/dyspraxia (pDCD) and 21 typically-developing (TD) adults (mean age 21 years). Eye tracking technology revealed that oculomotor response preparation in the pro- and anti-saccade tasks was comparable across groups, as was pursuit gain in the slower of the two smooth pursuit tasks. However, adults with pDCD made significantly more saccades away from the fixation target than those without DCD and significantly more anti-saccade errors. Further, compared to TD adults, adults with pDCD demonstrated difficulties in maintaining engagement and had lower pursuit gain in the faster pursuit task. This suggests that adults with pDCD have problems with saccadic inhibition and maintaining attention on a visual target. Since this pattern of results has also been reported in children with DCD, oculomotor difficulties may be persistent for those with DCD across the lifespan. An awareness of the impact of atypical oculomotor control in activities of daily living across the lifespan would support clearer understanding of the causes and impacts of these difficulties for those with DCD.
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  • 文章类型: Journal Article
    背景:边缘性人格障碍(BPD)与冲动增强有关,证据是药物滥用增加,自我伤害和自杀企图。在患有BPD的个体中解决冲动性是一个治疗目标;但其在该临床人群中的潜在神经基础仍不清楚。部分原因是其与注意力缺陷/多动障碍(ADHD)的常见合并症。
    方法:我们在伴随的基于视频的眼动追踪期间,在诊断为BPD伴和不伴ADHD(分别为N=25和N=24)的青少年中采用了反应抑制范式-交错的前/抗扫视任务(IPAST)。我们量化了各种眼动反应参数,反映了任务过程中的脉冲动作,包括延迟获取固定,固定断裂,预期扫视,快速扫视(扫视反应时间[SRT]:90-140ms)和常规扫视延迟(SRT>140ms)的方向误差。
    结果:患有BPD的个体表现出反应准备不足,例如,对任务线索的视觉固定减少和扫视反应的更大可变性(即,SRT和峰值速度)。ADHD/BPD组共享这些特征,并产生了预期响应和方向错误的频率增加,同时具有明显的扫视延迟和减少的纠错。
    结论:BPD和ADHD/BPD的扫视缺陷不是由于无法执行反扫视,而是由于对即将到来的任务集的准备不足。这些区别可能是由于皮质区域如额叶眼场的异常信号传导而产生的,顶叶后皮质,和前扣带皮质.了解这些机制可以提供对针对任务集准备的针对性干预措施的见解,以管理BPD和ADHD/BPD中的反应抑制缺陷。
    BACKGROUND: Borderline Personality Disorder (BPD) is associated with heightened impulsivity, evidenced by increased substance abuse, self-harm and suicide attempts. Addressing impulsivity in individuals with BPD is a therapeutic objective; but its underlying neural basis in this clinical population remains unclear, partly due to its frequent co-morbidity with attention-deficit/hyperactivity disorder (ADHD).
    METHODS: We employed a response inhibition paradigm - the interleaved pro-/anti-saccade task (IPAST) - among adolescents diagnosed with BPD with and without comorbid ADHD (N=25 and N=24, respectively) during concomitant video-based eye-tracking. We quantified various eye movement response parameters reflective of impulsive action during the task, including delay to fixation acquisition, fixation breaks, anticipatory saccades, and direction errors with express saccade (Saccade Reaction Time [SRT]: 90-140 ms) and regular saccade latencies (SRT > 140 ms).
    RESULTS: Individuals with BPD exhibited deficient response preparation, exampled by reduced visual fixation on task cues and greater variability of saccade responses (i.e., SRT and peak velocity). The ADHD/BPD group shared these traits, as well as produced an increased frequency of anticipatory responses and direction errors with express saccade latencies and reduced error correction.
    CONCLUSIONS: Saccadic deficits in BPD and ADHD/BPD stem not from an inability to execute anti-saccades, but rather from an inadequate preparation for the upcoming task set. These distinctions may arise due to abnormal signaling in cortical areas like the frontal eye fields, posterior parietal cortex, and anterior cingulate cortex. Understanding these mechanisms could provide insights into targeted interventions focusing on task set preparation to manage response inhibition deficits in BPD and ADHD/BPD.
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  • 文章类型: Journal Article
    赛季前运动测试可以建立脑震荡后比较的功能基线。这种测试是否可以预测未来脑震荡的影响鲜为人知。
    生成了两组脑震荡负担的模型:使用一系列逻辑回归的传统方法,以及使用弹性网的惩罚回归方法。
    对3091名青年和成年运动员进行了基线评估。90人随后经历了脑震荡,35人在两周内测试时仍经历了脑震荡的重大负担。两种模型都将头部受伤的既往史和与视觉注意力相关的指标与脑震荡的显着负担相关联。
    赛季前的视觉注意力测试可能会识别有重大运动相关脑震荡风险的运动员。
    运动季前测试可以建立脑震荡后比较的功能基线,并可以预测未来脑震荡的影响。在这项研究中,对3091名青年和成年运动员进行了基线评估。90人随后经历了脑震荡,35人在两周内测试时仍经历了脑震荡的重大负担。统计模型和机器学习模型都将头部损伤的先前历史和视觉注意力相关的度量与脑震荡的显著负担相关联。赛季前的视觉注意力测试可能会识别出有重大运动相关脑震荡风险的运动员。
    UNASSIGNED: Athletic pre-season testing can establish functional baseline for comparison following concussion. Whether impacts of future concussions may be foretold by such testing is little known.
    UNASSIGNED: Two sets of models for a significant burden of concussion were generated: a traditional approach using a series of logistic regressions, and a penalized regression approach using elastic net.
    UNASSIGNED: 3091 youth and adult athletes were baseline-assessed. 90 subsequently experienced concussion and 35 were still experiencing a significant burden of concussion when tested within two weeks. Both models associated prior history of head injury and visual attention-related metrics with a significant burden of concussion.
    UNASSIGNED: Pre-season testing of visual attention may identify athletes who are at risk for significant sports-related concussion.
    Athletic pre-season testing can establish functional baseline for comparison following concussion and may predict impacts of future concussions. In this study, 3,091 youth and adult athletes were baseline-assessed. 90 subsequently experienced concussion and 35 were still experiencing a significant burden of concussion when tested within two weeks. A statistical model and a machine-learning model both associated prior history of head injury and visual attention-related metrics with a significant burden of concussion. Pre-season testing of visual attention may identify athletes who are at risk for significant sports-related concussion.
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  • 文章类型: Journal Article
    一次运动可以改善执行功能(EF),并且部分归因于运动介导的脑血流增加,从而提高了神经效率。有限的工作使用了与事件相关的协议来检查EF任务的准备阶段脑血流动力学的运动后变化。鉴于神经效率假说断言EF改善与大脑活动减少有关,这一点很明显。这里,使用事件相关的经颅多普勒超声测量有氧运动前15分钟和后15分钟的大脑中动脉速度(MCAv)的前(扫视到目标)和反扫视(扫视镜像对称目标)准备阶段.与前视相比,前视产生了更长的反应时间(RT)和增加的准备阶段MCAv-这一结果归因于反视的EF神经活性更大。运动后RT减少(ps<0.01);然而,反扫视准备阶段MCAv在运动前后没有变化(p=0.53),并且与反扫视RT获益不相关(p=0.31).因此,研究结果未提供证据表明,通过功能性充血建立的神经效率指数提高与运动后EF行为获益相关.相反,结果支持一种不断发展的观点,即EF获益代表了相互依赖的运动介导的神经生理学变化之间的加性相互作用.
    A single bout of exercise improves executive function (EF) and is a benefit - in part -attributed to an exercise-mediated increase in cerebral blood flow enhancing neural efficiency. Limited work has used an event-related protocol to examine postexercise changes in preparatory phase cerebral hemodynamics for an EF task. This is salient given the neural efficiency hypothesis\' assertion that improved EF is related to decreased brain activity. Here, event-related transcranial Doppler ultrasound was used to measure pro- (saccade to target) and antisaccades (saccade mirror-symmetrical target) preparatory phase middle cerebral artery velocity (MCAv) prior to and immediately after 15-min of aerobic exercise. Antisaccades produced longer reaction times (RT) and an increased preparatory phase MCAv than prosaccades - a result attributed to greater EF neural activity for antisaccades. Antisaccades selectively produced a postexercise RT reduction (ps < 0.01); however, antisaccade preparatory phase MCAv did not vary from pre- to postexercise (p=0.53) and did not correlate with the antisaccade RT benefit (p = 0.31). Accordingly, results provide no evidence that improved neural efficiency indexed via functional hyperemia is linked to a postexercise EF behavioural benefit. Instead, results support an evolving view that an EF benefit represents the additive interplay between interdependent exercise-mediated neurophysiological changes.
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  • 文章类型: Journal Article
    在过去的十年里,脑震荡研究在多个科学研究领域爆发。这有助于澄清是什么原因,影响力,并延续人类脑震荡,并展示物理治疗师在脑震荡管理中的不可或缺的作用。在本文中,我们讨论了与物理治疗在脑震荡管理中的关键作用有关的最新研究。对脑震荡的文献进行了叙述性回顾。当前的综述分析了脑震荡如何影响几类物理治疗:评估,治疗,管理,研究严谨,建立专业形象。科学脑震荡研究在很大程度上支持物理治疗师利用特定组件的作用,包括:(1)自主神经,(2)产宫颈,(3)前庭眼和(4)心理管理方法。最新研究支持物理治疗在脑震荡护理评估中的关键作用,管理,以及预防脑震荡,并有进一步跨学科合作的空间。
    脑震荡是复杂的。基本的心理健康,前庭眼球运动筛查(VOMS)和与脑震荡管理有关的四个关键组成部分(自主神经,产宫颈,前庭动眼力,和心理管理方法)应包括在本科和研究生课程中。这将有助于临床物理治疗师支持他们的患者。应鼓励促进更多学科内物理治疗团队合作的呼吁,因为在“专业化”的框架内可能会失去宝贵的知识共享。如果需要,一个更大的跨学科团队的技能是必要的,以促进患者管理和从这种多方面的伤害恢复。
    In the last decade, concussion research has exploded in multiple fields of scientific research. This has helped to clarify what causes, influences, and perpetuates human concussion, and displays the integral role physiotherapists play in concussion management. In this article we discuss the latest research relevant to the key role of physiotherapy in concussion management. A narrative review of the literature on concussion was conducted. The current review analyses how concussion has influenced physiotherapy in several categories: assessment, treatment, management, research rigour and building the profile of the profession. Scientific concussion research has largely converged in support of the role of physiotherapists utilising specific components including: (1) autonomic, (2) cervicogenic, (3) vestibulo-ocular and (4) psychological approaches to management. Latest research supports the critical role of physiotherapy in concussion care in the assessment, management, and prevention of concussion with scope for further interdisciplinary collaborations.
    UNASSIGNED: Concussion is complex. A basic mental health, Vestibular Ocular Motor Screening (VOMS) and four key components relating to concussion management (autonomic, cervicogenic, vestibular oculomotor, and psychological approaches to management) should be included in the undergraduate and postgraduate curriculum. This will aid clinical physiotherapists to support their patients. A call to advance more intradisciplinary physiotherapy teamwork should be encouraged as valuable knowledge sharing is potentially lost within the framework of \'specialisation\'. If needed, the skills of a greater interdisciplinary team are imperative to facilitate patient management and recovery from this multi-faceted injury.
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  • 文章类型: Journal Article
    视频眼图构成了一种高度敏感的表征眼球运动的方法,它可以检测到细微的运动前变化,并有助于帕金森病(PD)的早期诊断。
    为了研究特发性PD(iPD)和与LRRK2(L2PD)的G2019S变体相关的PD之间的潜在动眼差异,以及评估LRRK2的G2019S变体的无症状携带者的动眼功能。
    该研究招募了129名受试者:30名PD(16名iPD,14L2PD),23名无症状携带者,L2PD患者的13名非携带者亲属,和63个无关的HCs。视频眼图评估包括固定,假肢,反扫视,和记忆扫视测试。
    我们没有发现iPD和L2PD之间的显着差异。与对照组相比,PD患者表现出广泛的动眼缺陷,包括较大的微跳,高度垂直假肢,所有测试中的延迟增加,成功的反扫视和记忆扫视的百分比较低。非携带者亲属表现出具有帕金森病特征的动眼变化,如固定不稳定和高垂直扫视。无症状携带者与PD有许多相似之处,包括不稳定的固定和高度垂直的假肢的迹象;然而,他们能够达到与对照组相似的成功反扫视和记忆扫视的百分比,尽管以更长的延迟为代价。用BCEA区分无症状携带者和HCs的显著动眼参数的分类准确率范围为0.68~0.74,整体固定不稳定的标志,是分类精度最高的参数。
    iPD和LRRK2-G2019SPD患者似乎没有表现出不同的动眼特征。LRRK2突变的无症状携带者的几种动眼变化可以被认为是运动前生物标志物。
    UNASSIGNED: Video-oculography constitutes a highly-sensitive method of characterizing ocular movements, which could detect subtle premotor changes and contribute to the early diagnosis of Parkinson\'s disease (PD).
    UNASSIGNED: To investigate potential oculomotor differences between idiopathic PD (iPD) and PD associated with the G2019S variant of LRRK2 (L2PD), as well as to evaluate oculomotor function in asymptomatic carriers of the G2019S variant of LRRK2.
    UNASSIGNED: The study enrolled 129 subjects: 30 PD (16 iPD, 14 L2PD), 23 asymptomatic carriers, 13 non-carrier relatives of L2PD patients, and 63 unrelated HCs. The video-oculographic evaluation included fixation, prosaccade, antisaccade, and memory saccade tests.
    UNASSIGNED: We did not find significant differences between iPD and L2PD. Compared to controls, PD patients displayed widespread oculomotor deficits including larger microsaccades, hypometric vertical prosaccades, increased latencies in all tests, and lower percentages of successful antisaccades and memory saccades. Non-carrier relatives showed oculomotor changes with parkinsonian features, such as fixation instability and hypometric vertical saccades. Asymptomatic carriers shared multiple similarities with PD, including signs of unstable fixation and hypometric vertical prosaccades; however, they were able to reach percentages of successful antisaccade and memory saccades similar to controls, although at the expense of longer latencies. Classification accuracy of significant oculomotor parameters to differentiate asymptomatic carriers from HCs ranged from 0.68 to 0.74, with BCEA, a marker of global fixation instability, being the parameter with the greatest classification accuracy.
    UNASSIGNED: iPD and LRRK2-G2019S PD patients do not seem to display a differential oculomotor profile. Several oculomotor changes in asymptomatic carriers of LRRK2 mutations could be considered premotor biomarkers.
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  • 文章类型: Journal Article
    响应于大视野视觉运动(视动刺激)的左平滑追踪眼动训练已成为左空间注意力不集中或忽视的一种有前途的康复方法。潜在的治疗效果的机制,然而,仍然未知。在视动刺激期间,视线前方的视觉定位存在误差。这可能表明大脑对自己注视方向的估计发生了变化。我们假设视动刺激改变了大脑对注视的估计。因为这种估计对于在相对于身体的视觉空间中以及在整个感官模式中编码注意力的轨迹至关重要,它的变化可能是空间注意力变化的基础。这里,我们报告说,在健康参与者中,视动刺激不仅会导致眼外肌本体感觉信号的方向偏差,但也有相应的注意力转移。两种变化都超过了刺激期。此结果形成了研究感觉运动凝视信号中的适应与空间忽略中的恢复之间的因果联系的步骤。
    Left smooth pursuit eye movement training in response to large-field visual motion (optokinetic stimulation) has become a promising rehabilitation method in left spatial inattention or neglect. The mechanisms underlying the therapeutic effect, however, remain unknown. During optokinetic stimulation, there is an error in visual localisation ahead of the line of sight. This could indicate a change in the brain\'s estimate of one\'s own direction of gaze. We hypothesized that optokinetic stimulation changes the brain\'s estimate of gaze. Because this estimate is critical for coding the locus of attention in the visual space relative to the body and across sensory modalities, its change might underlie the change in spatial attention. Here, we report that in healthy participants optokinetic stimulation causes not only a directional bias in the proprioceptive signal from the extraocular muscles, but also a corresponding shift of the locus of attention. Both changes outlasted the period of stimulation. This result forms a step in investigating a causal link between the adaptation in the sensorimotor gaze signals and the recovery in spatial neglect.
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  • 文章类型: Journal Article
    目的:原发性开角型青光眼(POAG)伴随着整个大脑的灰质(GM)变化。然而,转基因变化的因果关系尚未得到充分理解。我们的目的是使用Granger因果关系(GC)分析和结构MRI研究POAG中GM进行性变化的因果关系。
    方法:收集20名健康对照者和30名眼压升高的POAG患者的结构MRI。我们在对照组和POAG组之间进行了体素GM体积比较,在对照组和四个POAG亚组之间(按IOP分类)。然后,我们对所有POAG患者的结构MRI数据进行了测序,并进行了体素和感兴趣区域(ROI)GC分析,以调查POAG脑GM体积变化的因果关系.
    结果:与健康对照组相比,发现大脑中的转基因体积减少,丘脑的GM体积增大,在POAG脑中也观察到尾状核和cuneus(错误发现率(FDR)校正为q<0.05)。随着IOP升高,小脑和额叶的GM体积减少更严重.GC分析显示双侧小脑,视觉皮层,额叶区域独立地作为定向因果网络的主要枢纽,以及对大脑顶叶和颞区的预测因果效应(在q<0.05时校正的FDR)。
    结论:POAG在整个大脑中表现出进行性GM改变,以动眼区域和视觉皮层作为独立的主要枢纽。目前的结果可能会加深我们对POAG神经病理学的理解。
    OBJECTIVE: Primary open-angle glaucoma (POAG) is accompanied with gray matter (GM) changes across the brain. However, causal relationships of the GM changes have not been fully understood. Our aim was to investigate the causality of GM progressive changes in POAG using Granger causality (GC) analysis and structural MRI.
    METHODS: Structural MRI from 20 healthy controls and 30 POAG patients with elevated intraocular pressure (IOP) were collected. We performed voxel-wise GM volume comparisons between control and POAG groups, and between control and four POAG subgroups (categorized by IOP). Then, we sequenced the structural MRI data of all POAG patients and conducted both voxel-wise and region of interest (ROI)-wise GC analysis to investigate the causality of GM volume changes in POAG brain.
    RESULTS: Compared to healthy controls, reduced GM volumes across the brain were found, GM volume enlargements in the thalamus, caudate nucleus and cuneus were also observed in POAG brain (false discovery rate (FDR) corrected at q< 0.05). As IOP elevated, the reductions of GM volume were more severe in the cerebellum and frontal lobe. GC analysis revealed that the bilateral cerebellum, visual cortices, and the frontal regions served independently as primary hubs of the directional causal network, and projected causal effects to the parietal and temporal regions of the brain (FDR corrected at q<0.05).
    CONCLUSIONS: POAG exhibits progressive GM alterations across the brain, with oculomotor regions and visual cortices as independent primary hubs. The current results may deepen our understanding of neuropathology of POAG.
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