Alterations in Spontaneous Neuronal Activity and Microvascular Density of the Optic Nerve Head in Active Thyroid-Associated Ophthalmopathy

Abstract

PurposeTo investigate changes in local spontaneous brain activity in patients with active thyroid-associated ophthalmopathy (TAO) and explore the relationship between such alterations and microvascular indices.MethodsThirty-six active TAO patients with active phase and 39 healthy controls (HCs) were enrolled in this study. All participants underwent resting-state functional magnetic resonance imaging (rs-fMRI), neuropsychological tests, and ophthalmological examinations. The rs-fMRI-based fractional low-frequency fluctuation amplitude (fALFF) analysis methods were used to assess spontaneous brain activity in both groups. The structure (peripapillary retinal nerve fiber layer, pRNFL) and microvascular indices (the optic nerve head (ONH) whole image vessel density, ONH-wiVD, and peripapillary vessel density) were analyzed through optical coherence tomographic angiography imaging. The relationship between abnormal spontaneous brain activity and ophthalmological indices was analyzed using the Spearman’s rank correlation analysis.ResultsCompared with HCs, active TAO patients had increased fALFF in the right inferior temporal gyrus (R.ITG) and left posterior cingulate gyrus (L.PCC), but decreased fALFF in the right calcarine (R.CAL). The fALFF values in L.PCC were positively correlated with peripapillary vessel density, whereas fALFF values in R.CAL were negatively related to peripapillary vessel density.ConclusionsThis study demonstrates that changes in spontaneous brain activity of active TAO are accompanied by peripapillary microvascular variations. These results provide insights into the pathophysiological mechanisms of active TAO. In addition, the combination of fALFF values and peripapillary vessel density may be served as important references for better clinical decision making.

Artificial Intelligence Applications in Chronic Ocular Diseases

“…Compared with HCs, patients with active TAO demonstrated decreased fALFF in the right calcarine (Zhu et al, 2022) and decreased FC between hemispheric calcarine gyri (Qi et al, 2022;Wen et al, 2022). The microvascular density of the optic nerve head has been negatively correlated with fALFF in the right calcarine (Zhu et al, 2022). Patients with TAO and in the euthyroid status showed decreased fALFF in the bilateral calcarine (Chen et al, 2021d) and decreased VMHC in lingual gyri/ calcarine .…”

“…Dysfunction in the primary visual cortex is a common finding among various eye diseases such as glaucoma (Chen et al, 2022b), diabetic retinopathy , exotropia and amblyopia (Liang et al, 2016;, and optic neuropathy (Sujanthan et al, 2022). Compared with HCs, patients with active TAO demonstrated decreased fALFF in the right calcarine (Zhu et al, 2022) and decreased FC between hemispheric calcarine gyri (Qi et al, 2022;Wen et al, 2022). The microvascular density of the optic nerve head has been negatively correlated with fALFF in the right calcarine (Zhu et al, 2022).…”

Whole-orbit radiomics: machine learning-based multi- and fused- region radiomics signatures for intravenous glucocorticoid response prediction in thyroid eye disease

“…However, the potential of radiomics for TED therapy response prediction could be further enhanced. Despite EOMs, other vital structures in the orbit, such as lacrimal gland (LG) [19], orbital fat (OF) [20], and optic nerve (ON) [21], also undergo distinct changes in the pathogenesis of TED. The predictive value of these structures has been confirmed in several imaging studies [22][23][24].…”

Altered dynamic brain activity and functional connectivity in thyroid‐associated ophthalmopathy

“…Studies on structural neuroimaging have identified morphological and microstructural abnormalities associated with visual and cognitive deficits in TAO patients (Silkiss & Wade, 2016 ; Wu et al, 2020 ). Researches based on resting‐state functional magnetic resonance imaging (rs‐fMRI) revealed that TAO patients exhibited abnormal functional changes in several brain networks, primarily within the visual network (Chen, Wu, Chen, Zhou, Chen, Xu, Hu, & Wu, 2021 ; Chen, Wu, Chen, Zhou, Chen, Xu, Wu, & Hu, 2021 ; Zhu et al, 2022 ). However, the previous functional investigations mostly concentrated on the alterations of localized brain activity, especially using amplitude of low‐frequency fluctuation (ALFF), one of the most reproducible and reliable fMRI parameters (Zhi et al, 2019 ).…”