The abnormal fractional amplitude of low-frequency fluctuation changes in patients with diabetic optic neuropathy: a steady-state fMRI study.

The spontaneous changes in brain activity in patients with diabetic optic neuropathy using steady-state fMRI. The fractional amplitude of the low-frequency fluctuation method was applied to evaluate neural activity changes. The Hospital Anxiety and Depression Scale was used to assess the anxiety and depression status of participants. The independent sample t-test and chi-squared test were applied to analyze the demographics of diabetic optic neuropathy patients and healthy controls. Receiver operating characteristic curves were applied to analyze the variation in mean fractional amplitude of low-frequency fluctuation values between diabetic optic neuropathy patients and healthy controls. Pearson's correlation analysis analyzed the relationships between the fractional amplitude of low-frequency fluctuation values of brain regions and clinical behaviors in the diabetic optic neuropathy group. The fractional amplitude of low-frequency fluctuation value of diabetic optic neuropathy patients was significantly higher than healthy controls in the right precentral gyrus. However, the fractional amplitude of low-frequency fluctuation values in the right anterior cingulate gyrus and left middle cingulate gyrus were markedly decreased in diabetic optic neuropathy patients. The area under the curve of receiver operating characteristics for each brain region showed high accuracy. Pearson's correlation analysis showed that fractional amplitude of low-frequency fluctuation values of the right anterior cingulate gyrus and left middle cingulate gyrus was negatively correlated with Hospital Anxiety and Depression Scale scores. The fractional amplitude of low-frequency fluctuation values of the left middle cingulate gyrus was negatively correlated with diabetic optic neuropathy disease duration. In conclusion, we found abnormal spontaneous brain activities in regions related to cognitive and emotional dysfunction, eye movement disorder, and vision loss in patients with diabetic optic neuropathy. These results may indicate the underlying neuropathological mechanisms of diabetic optic neuropathy and show that fractional amplitude of low-frequency fluctuation may be an effective method to distinguish patients with diabetic optic neuropathy from healthy individuals.

Graph theoretical analysis and independent component analysis of diabetic optic neuropathy: A resting-state functional magnetic resonance imaging study.

AIMS: This study aimed to investigate the resting-state functional connectivity and topologic characteristics of brain networks in patients with diabetic optic neuropathy (DON). METHODS: Resting-state functional magnetic resonance imaging scans were performed on 23 patients and 41 healthy control (HC) subjects. We used independent component analysis and graph theoretical analysis to determine the topologic characteristics of the brain and as well as functional network connectivity (FNC) and topologic properties of brain networks. RESULTS: Compared with HCs, patients with DON showed altered global characteristics. At the nodal level, the DON group had fewer nodal degrees in the thalamus and insula, and a greater number in the right rolandic operculum, right postcentral gyrus, and right superior temporal gyrus. In the internetwork comparison, DON patients showed significantly increased FNC between the left frontoparietal network (FPN-L) and ventral attention network (VAN). Additionally, in the intranetwork comparison, connectivity between the left medial superior frontal gyrus (MSFG) of the default network (DMN) and left putamen of auditory network was decreased in the DON group. CONCLUSION: DON patients altered node properties and connectivity in the DMN, auditory network, FPN-L, and VAN. These results provide evidence of the involvement of specific brain networks in the pathophysiology of DON.

Amplitude of Low-Frequency Fluctuation to Determine Disturbed Spontaneous Brain-Activity Pattern in Patients with Diabetic Optic Neuropathy.

Purpose: This study aimed to explore the spontaneous brain activity in patients with diabetic optic neuropathy (DON) by using the amplitude of low-frequency fluctuation (ALFF) technique. Methods: Sixteen DON patients and 16 age- and sex-matched healthy controls (HCs) were recruited. ALFF along with functional MRI method was used to detect the intrinsic brain activity alterations. The mean values of ALFF in DON patients and HCs were analyzed by receiver operating characteristic (ROC) curves. Pearson's correlation analysis was used to determine the correlation between Hospital Anxiety and Depression Scale (HADS) and ALFF values of DONs. Results: The DON group showed significantly increased ALFF values in the fusiform gyrus, and decreased ALFF values in the medial frontal gyrus/left frontal superior orbit/right frontal medial orbit, and left frontal inferior triangle. ROC curve analysis indicated that the accuracy of AUC was good. The anxiety scale and depression scale of the DON group were negatively correlated with the ALFF values of the medial frontal gyrus. Conclusion: DON is a neurodegenerative disease involving multiple brain regions. The abnormal activity of neurons in these brain regions helps to reveal the underlying neural mechanisms of brain activity related to DON.

Multimodal and multi-omics-based deep learning model for screening of optic neuropathy.

Purpose: To examine the use of multimodal data and multi-omics strategies for optic nerve disease screening. Methods: This was a single-center retrospective study. A deep learning model was created from fundus photography and infrared reflectance (IR) images of patients with diabetic optic neuropathy, glaucomatous optic neuropathy, and optic neuritis. Patients who were seen at the Ophthalmology Department of First Affiliated Hospital of Nanchang University in Jiangxi Province from November 2019 to April 2023 were included in this study. The data were analyzed in single and multimodal modes following the traditional omics, Resnet101, and fusion models. The accuracy and area-under-the-curve (AUC) of each model were compared. Results: A total of 312 images fundus and infrared fundus photographs were collected from 156 patients. When multi-modal data was used, the accuracy of the traditional omics mode, Resnet101, and fusion models with the training set were 0.97, 0.98, and 0.99, respectively. The accuracy of the same models with the test sets were 0.72, 0.87, and 0.88, respectively. We compared single- and multi-mode states by applying the data to the different groups in the learning model. In the traditional omics model, the macro-average AUCs of the features extracted from fundus photography, IR images, and multimodal data were 0.94, 0.90, and 0.96, respectively. When the same data were processed in the Resnet101 model, the scores were 0.97 equally. However, when multimodal data was utilized, the macro-average AUCs in the traditional omics, Resnet101, and fusion modesl were 0.96, 0.97, and 0.99, respectively. Conclusion: The deep learning model based on multimodal data and multi-omics strategies can improve the accuracy of screening and diagnosing diabetic optic neuropathy, glaucomatous optic neuropathy, and optic neuritis.

Hyperintensities of middle frontal gyrus in patients with diabetic optic neuropathy: a dynamic amplitude of low-frequency fluctuation study.

Diabetic optic neuropathy (DON) is a diverse complication of diabetes and its pathogenesis has not been fully elucidated. The purpose of this study was to explore dynamic cerebral activity changes in DON patients using dynamic amplitude of low-frequency fluctuation (dALFF). In total, 22 DON patients and 22 healthy controls were enrolled. The dALFF approach was used in all participants to investigate dynamic intrinsic brain activity differences between the two groups. Compared with HCs, DON patients exhibited significantly increased dALFF variability in the right middle frontal gyrus (P < 0.01). Conversely, DON patients exhibited obviously decreased dALFF variability in the right precuneus (P < 0.01). We also found that there were significant negative correlations between HADS scores and dALFF values of the right middle frontal gyrus in the DON patients (r = -0.6404, P <0.01 for anxiety and r = -0.6346, P <0.01 for depression; HADS, Hospital Anxiety and Depression Scale). Abnormal variability of dALFF was observed in specific areas of the cerebrum in DON patients, which may contribute to distinguishing patients with DON from HCs and a better understanding of DON, hyperintensities of right middle frontal gyrus may be potential diagnostic marker for DON.

Interhemispheric Functional Connectivity Alterations in Diabetic Optic Neuropathy: A Resting-State Functional Magnetic Resonance Imaging Study.

PURPOSE: Previous research suggests that diabetic optic neuropathy (DON) can cause marked anatomical and functional variations in the brain, but to date altered functional synchronization between two functional hemispheres remains uncharacterized in DON patients. Voxel mirrored homotopic connectivity (VMHC) is a voxel-based method to evaluate the synchronism between two mirrored hemispheric by determining the functional connectivity between each voxel in one hemisphere and its counterpart. In this study, we aim to assess abnormal changes in interhemispheric functional connectivity in DON patients via the VMHC method. METHODS: The study included 28 adult DON patients (12 male, 16 female) and 28 healthy controls (12 male, 16 female) who were closely matched for sex and age. Participants were examined using resting-state functional magnetic resonance imaging. The VMHC method was applied to investigate the abnormal state in bilateral hemispheres in DON patients and the same regions in healthy controls, as well as the receiver operating characteristic (ROC) curves were used to evaluate characteristics. Associations between altered VMHC values in distinct cerebral regions and clinical features were assessed via correlational analysis. RESULTS: Markedly lower VMHC values were evident in the right temporal inferior, the left temporal inferior, the right mid-cingulum, the left mid-cingulum, the right supplementary motor region, and the left supplementary motor region in DON patients compared with healthy controls. ROC curve analysis suggested that the application of VMHC is reliable for the diagnosis of DON. CONCLUSION: Anomalous interhemispheric functional connectivity in specific brain areas caused by DON may indicate neuropathologic mechanisms of vision loss and blurry vision in patients with DON.

Altered spontaneous brain activity in patients with diabetic optic neuropathy: A resting-state functional magnetic resonance imaging study using regional homogeneity.

BACKGROUND: Diabetes is a common chronic disease. Given the increasing incidence of diabetes, more individuals are affected by diabetic optic neuropathy (DON), which results in decreased vision. Whether DON leads to abnormalities of other visual systems, including the eye, the visual cortex, and other brain regions, remains unknown. AIM: To investigate the local characteristics of spontaneous brain activity using regional homogeneity (ReHo) in patients with DON. METHODS: 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. RESULTS: 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). CONCLUSION: Three different brain regions show ReHo changes in DON patients, and these changes could serve as diagnostic and/or prognostic biomarkers to further guide the prevention and treatment of DON patients.

Regional brain changes in patients with diabetic optic neuropathy: a resting-state functional magnetic resonance imaging study.

BACKGROUND: To evaluate functional connection density (FCD) in patients with diabetic optic neuropathy (DON) using the resting functional connectivity (FC) method, and to determine the abnormal areas of brain activity. METHODS: Patients with DON (n=22; 10 male, 12 female) and healthy controls (HCs; n=22; 10 male, 12 female) were included in the study. The basic characteristics of the groups were matched. Functional magnetic resonance imaging (fMRI) was conducted with participants at rest, and long- and short-range FCD (long FCD and IFCD, respectively) were measured. Receiver operating characteristic (ROC) curve analysis was also conducted to determine whether DON and HC participants could be distinguished using fMRI indicators. RESULTS: Compared with HCs, the long FCD values of the left lingual gyrus, right lingual gyrus, right fusiform gyrus, and medial and lateral cingulate gyri were decreased in patients with DON. Further, the IFCD values of the left superior temporal gyrus, left inferior temporal gyrus, right inferior temporal gyrus, left cerebellar area 8, and right cerebellar Crus2 area were higher in patients with DON than in the HCs. CONCLUSIONS: DON is associated with abnormal spontaneous brain activity. Our findings contribute to elucidating the mechanisms underlying the neuropathology of DON, and provide direction for further clinical research.

Characteristics of optical coherence tomography image in diabetic optic neuropathy / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyze the characteristics of optical coherence tomography ( OCT ) in diabetic optic neuropathy ( DON ) retrospectively. ●METHODS:Retrospective study. A total of 175 cases of type ll diabetes with fundus lesions from Dec. 2013 to Dec. 2015 were selected and the clinical information was collected. These cases were diagnosed by consultation between Departments of Ophthalmology and Endocrinology in the Second Affiliated Hospital of Xi′an Jiao Tong University. The results of body examination were recorded and cases were examined by color fundus photography, fluorescein fundus angiography ( FFA) and OCT. All these data were analyzed. ●RESULTS: A total of 49 cases ( 90 eyes, 25. 7%) were diagnosed DON through FFA which manifested abnormal fluorescence in optic papilla. Results of OCT showed:among 90 eyes of DON patients, 15 eyes ( 16. 7%) had normal optic nerve form; 20 eyes(22. 2%) of excavation of optic disc became smaller or disappeared, with prelaminar tissue and peripapillary retinal nerve fiber layer (RNFL) swelling;26 eyes (28. 9%) manifested optic cup deep and cup/disc ratio increasing;18 eyes (20. 0%) had tissue hyperplasia in the hollow or on the surface of optic disc; 11 eyes(12. 3%) had symptoms including vitreous traction optic papilla and optic disc rim rising. DON eyes which had similar fluorescence features could manifest different tissue morph by OCT. ●CONCLUSION: FFA defines DON by change of blood circulation in optic nerve. However, OCT can show differences of tissue morph of optic nerve that FFA fails to do. So OCT can manifest the causes and sites of optic neuropathy more clearly and also provide basis for treatment. The advantages of OCT are conducive to reviews and curative effect tracking among DON patients and these advantages including noninvasive, convenient, inexpensive and repeatable.