title: Evidence for widespread structural brain changes in glaucoma: a preliminary voxel-based MRI study.
abstract: OBJECTIVE
  To investigate structural brain changes in patients with glaucoma.
  
  
  METHODS
  High-resolution T1-weighted anatomical brain magnetic resonance images (MRI) were collected in 15 patients with glaucoma of varying severity and in 15 age-, race-, and sex-matched controls. Exclusion criteria included neurological disease, another disorder which could affect the visual field, and a score of less than 25 on the mini-mental status examination. The scans were analyzed with an automatic volumetric MRI technique to measure the volumes of 93 structures in each brain. Analyses of covariance with age as a covariate were carried out to identify structures that differed significantly between the two groups (i.e., glaucoma versus normal control). The volumes of all brain structures in the group of 15 glaucoma patients were also correlated with clinical measures of disease severity. Linear multivariate regression analyses were conducted to determine the significance of these relationships.
  
  
  RESULTS
  Five structures differed significantly between the two groups (P < 0.05). These structures included the right and left inferior occipital gyri and the right middle occipital gyrus, right inferior temporal gyrus, and right occipital lobe white matter. Interestingly, all of these structures were larger in the glaucoma group than in the control group. Within the group of glaucoma patients, 38% of all brain structures had independent associations between decreasing volume and more severe disease in multivariate regression analysis.
  
  
  CONCLUSIONS
  These results suggest that patients with glaucoma undergo widespread and complex changes in cortical brain structure and that the extent of these changes correlates with disease severity.
authors.affiliation: William A. and Anna V. Goldberg Glaucoma Service, Wills Eye Institute, Philadelphia, Pennsylvania, USA.
authors.forename: Alice L
authors.initials: AL
authors.lastname: Williams
authors.forename: John
authors.initials: J
authors.lastname: Lackey
authors.forename: Sheryl S
authors.initials: SS
authors.lastname: Wizov
authors.forename: Tao Ming Thomas
authors.initials: TM
authors.lastname: Chia
authors.forename: Srinivas
authors.initials: S
authors.lastname: Gatla
authors.forename: Mark L
authors.initials: ML
authors.lastname: Moster
authors.forename: Robert
authors.initials: R
authors.lastname: Sergott
authors.forename: George L
authors.initials: GL
authors.lastname: Spaeth
authors.forename: Song
authors.initials: S
authors.lastname: Lai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001921:Brain / Q000473:pathology*; D005260:Female; D005901:Glaucoma / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012720:Severity of Illness Index; D014792:Visual Acuity / Q000502:physiology
keywords: glaucoma; structural MRI; voxel-based morphometry