Published online Mar 15, 2021. doi: 10.4239/wjd.v12.i3.278
Peer-review started: November 20, 2020
First decision: December 24, 2020
Revised: December 30, 2020
Accepted: February 11, 2021
Article in press: February 11, 2021
Published online: March 15, 2021
Diabetes is a common chronic disease. Given the increasing incidence of diabetes, more individuals are affected by diabetic optic neuropathy (DON), resulting in decreased vision. Whether DON leads to abnormalities of other visual systems, including the eye, the visual cortex, and other brain regions, remains unknown.
We are more concerned about the damage of DON to the optic disc and vision nowadays, and whether DON leads to abnormalities of other visual systems, including the eye, the visual cortex, and other brain regions remains unknown. In this study, we investigated the underlying regional homogeneity (ReHo) of brain-activity abnormalities in patients with DON and their relationship with clinical features. Our study may contribute to understanding altered neural mechanisms present in patients with DON.
The aim of the current study was to use ReHo to investigate the local characteristics of spontaneous brain activity in patients with diabetic optic neuropathy and brain activity deficits and to identify the underlying pathophysiological mechanisms of DON.
We matched 22 patients with DON with 22 healthy controls (HCs). All subjects underwent resting-state functional magnetic resonance imaging. The ReHo technique was used to record spontaneous changes in brain activity. Receiver operating characteristic (ROC) curves were applied to differentiate between ReHo values for patients with DON and HCs. We also assessed the correlation between Hospital Anxiety and Depression Scale scores and ReHo values in DON patients using Pearson correlation analysis.
ReHo values of the right middle frontal gyrus (RMFG), left anterior cingulate (LAC), and superior frontal gyrus (SFG)/left frontal superior orbital gyrus (LFSO) were significantly lower in DON patients compared to HCs. Among these, the greatest difference was observed in the RMFG. The result of the ROC curves suggest that ReHo values in altered brain regions may help diagnose DON, and the RMFG and LAC ReHo values are more clinically relevant than SFG/LFSO. We also found that anxiety and depression scores of the DON group were extremely negatively correlated with the LAC ReHo values (r = -0.9336, P < 0.0001 and r = -0.8453, P < 0.0001, respectively).
Three different brain regions show ReHo changes in DON patients, and these changes could serve as diagnostic and/or prognostic biomarkers for patients with DON. They could also guide the development of new measures to prevent and treat optic neuropathy.
We have identified three different regions of brain dysfunction in DON patients, including the RMFG, LAC, and SFG/LFSO. The RMFG brain region has the most significant decrease and the highest diagnostic value, suggesting that it could be used to study how optic neuropathy develops in patients with diabetes. Changes of spontaneous brain activity in different brain regions show different ReHo values, thus revealing brain activity in DON patients.