Altered Static and Dynamic Interhemispheric Resting-State Functional Connectivity in Patients With Thyroid-Associated Ophthalmopathy.

Wen Chen,Hao Hu,Huan-Huan Chen,Fei-Yun Wu,Jiang Zhou,Xiao-Quan Xu,Qian Wu,Lu Chen

doi:10.3389/fnins.2021.799916

Abstract

Purpose: Thyroid-associated ophthalmopathy (TAO) is a debilitating and sight-threatening autoimmune disease that severely impairs patients’ quality of life. Besides the most common ophthalmic manifestations, the emotional and psychiatric disturbances are also usually observed in clinical settings. This study was to investigate the interhemispheric functional connectivity alterations in TAO patients using resting-state functional magnetic resonance imaging (rs-fMRI).Methods: Twenty-eight TAO patients and 22 healthy controls (HCs) underwent rs-fMRI scans. Static and dynamic voxel-mirrored homotopic connectivity (VMHC) values were calculated and compared between the two groups. A linear support vector machine (SVM) classifier was used to examine the performance of static and dynamic VMHC differences in distinguishing TAOs from HCs.Results: Compared with HCs, TAOs showed decreased static VMHC in lingual gyrus (LG)/calcarine (CAL), middle occipital gyrus, postcentral gyrus, superior parietal lobule, inferior parietal lobule, and precuneus. Meanwhile, TAOs demonstrated increased dynamic VMHC in orbitofrontal cortex (OFC). In TAOs, static VMHC in LG/CAL was positively correlated with visual acuity (r = 0.412, P = 0.036), whilst dynamic VMHC in OFC was positively correlated with Hamilton Anxiety Rating Scale (HARS) score (r = 0.397, P = 0.044) and Hamilton Depression Rating Scale (HDRS) score (r = 0.401, P = 0.042). The SVM model showed good performance in distinguishing TAOs from HCs (area under the curve, 0.971; average accuracy, 94%).Conclusion: TAO patients had altered static and dynamic VMHC in the occipital, parietal, and orbitofrontal areas, which could serve as neuroimaging prediction markers of TAO.

Highlights

Thyroid-associated ophthalmopathy (TAO), known as Graves’ orbitopathy or endocrine exophthalmos, is a vision-disabling and disfiguring autoimmune disease, severely impacting the life quality, mental health, and socioeconomic status of the patients (Roos and Murthy, 2019; Taylor et al, 2020)
In TAOs, static voxel-mirrored homotopic connectivity (VMHC) in lingual gyrus (LG)/CAL was positively correlated with visual acuity (r = 0.412, P = 0.036), whilst dynamic VMHC in orbitofrontal cortex (OFC) was positively correlated with Hamilton Anxiety Rating Scale (HARS) score (r = 0.397, P = 0.044) and Hamilton Depression Rating Scale (HDRS) score (r = 0.401, P = 0.042)
TAO patients had altered static and dynamic VMHC in the occipital, parietal, and orbitofrontal areas, which could serve as neuroimaging prediction markers of TAO

Summary

Introduction

Thyroid-associated ophthalmopathy (TAO), known as Graves’ orbitopathy or endocrine exophthalmos, is a vision-disabling and disfiguring autoimmune disease, severely impacting the life quality, mental health, and socioeconomic status of the patients (Roos and Murthy, 2019; Taylor et al, 2020). It has been observed that TAO patients had higher levels of anxiety and depression than people with other chronic diseases or facial disfigurements (Wickwar et al, 2015). A cohort study showed that TAO patients had a significantly higher risk of suicide (Ferlov-Schwensen et al, 2017). All these psychiatric signs suggested that TAO may be related to neuropsychic alterations rather than simple ophthalmic involvement (Bruscolini et al, 2018)

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