title: Structural and functional brain changes beyond visual system in patients with advanced glaucoma.
abstract: In order to test the hypothesis that in primary open angle glaucoma (POAG), an important cause of irreversible blindness, a spreading of neurodegeneration occurs through the brain, we performed multimodal MRI and subsequent whole-brain explorative voxelwise analyses in 13 advanced POAG patients and 12 age-matched normal controls (NC). Altered integrity (decreased fractional anisotropy or increased diffusivities) of white matter (WM) tracts was found not only along the visual pathway of POAG but also in nonvisual WM tracts (superior longitudinal fascicle, anterior thalamic radiation, corticospinal tract, middle cerebellar peduncle). POAG patients also showed brain atrophy in both visual cortex and other distant grey matter (GM) regions (frontoparietal cortex, hippocampi and cerebellar cortex), decreased functional connectivity (FC) in visual, working memory and dorsal attention networks and increased FC in visual and executive networks. In POAG, abnormalities in structure and FC within and outside visual system correlated with visual field parameters in the poorer performing eyes, thus emphasizing their clinical relevance. Altogether, this represents evidence that a vision disorder such as POAG can be considered a widespread neurodegenerative condition.
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Frezzotti
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Giorgio
authors.affiliation: Department of Ophthalmology, University of Genoa, Genoa, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Motolese
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: De Leucio
authors.affiliation: Department of Ophthalmology, University of Genoa, Genoa, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Iester
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Motolese
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Federico
authors.affiliation: Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
authors.forename: Nicola
authors.initials: N
authors.lastname: De Stefano
mesh_terms: D000328:Adult; D020643:Anterior Thalamic Nuclei / Q000473:pathology / Q000503:physiopathology; D001284:Atrophy; D001931:Brain Mapping; D016022:Case-Control Studies; D002525:Cerebellar Cortex / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005902:Glaucoma, Open-Angle / Q000473:pathology* / Q000503:physiopathology; D066128:Gray Matter / Q000473:pathology* / Q000503:physiopathology; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D065837:Middle Cerebellar Peduncle / Q000473:pathology / Q000503:physiopathology; D064847:Multimodal Imaging; D011712:Pyramidal Tracts / Q000473:pathology / Q000503:physiopathology; D013003:Somatosensory Cortex / Q000473:pathology / Q000503:physiopathology; D014793:Visual Cortex / Q000473:pathology* / Q000503:physiopathology; D014795:Visual Pathways / Q000473:pathology* / Q000503:physiopathology; D066127:White Matter / Q000473:pathology* / Q000503:physiopathology