Disrupted Spontaneous Neural Activity in Patients With Thyroid-Associated Ophthalmopathy: A Resting-State fMRI Study Using Amplitude of Low-Frequency Fluctuation.

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

doi:10.3389/fnhum.2021.676967

Abstract

PurposeThe purpose of the study was to investigate the brain functional alteration in patients with thyroid-associated ophthalmopathy (TAO) by evaluating the spontaneous neural activity changes using resting-state functional magnetic resonance imaging (rs-fMRI) with the amplitude of low-frequency fluctuation (ALFF) method.Materials and MethodsThe rs-fMRI data of 30 TAO patients (15 active and 15 inactive) and 15 healthy controls (HCs) were included for analyses. The ALFF values were calculated and compared among groups. Correlations between ALFF values and clinical metrics were assessed.ResultsCompared with HCs, active TAOs showed significantly decreased ALFF values in the left middle occipital gyrus, superior occipital gyrus, and cuneus. Compared with inactive TAOs, active TAOs showed significantly increased ALFF values in the bilateral precuneus. Additionally, inactive TAOs showed significantly decreased ALFF values in the left middle occipital gyrus, superior occipital gyrus, cuneus, and bilateral precuneus than HCs. The ALFF value in the right precuneus of TAOs was positively correlated with clinical activity score (r = 0.583, P < 0.001) and Mini-Mental State Examination (MMSE) score (r = 0.377, P = 0.040), and negatively correlated with disease duration (r = −0.382, P = 0.037). Moreover, the ALFF value in the left middle occipital gyrus of TAOs was positively correlated with visual acuity (r = 0.441, P = 0.015).ConclusionTAO patients had altered spontaneous brain activities in the left occipital lobe and bilateral precuneus. The neuropsychological aspect of the disease should be noticed during clinical diagnosis and treatment.

Highlights

Thyroid-associated ophthalmopathy (TAO) is the most common autoimmune inflammatory orbital disease (Sahli and Gunduz, 2017)
There was no significant difference in the ratio of antithyroid medication history (P = 0.483), the quality of life (QoL) scores for visual functioning (P = 0.267), or appearance (P = 0.744) between the active and inactive TAO groups
Significant differences were found in the visual acuity (P = 0.002) and total scores of Hamilton Depression Rating Scale (HDRS) (P < 0.001), Hamilton Anxiety Rating Scale (HARS) (P < 0.001), and Mini-Mental State Examination (MMSE) (P = 0.002) among the three groups

Summary

Introduction

Thyroid-associated ophthalmopathy (TAO) is the most common autoimmune inflammatory orbital disease (Sahli and Gunduz, 2017). During the acute active phase, pathological inflammatory changes, including lymphocyte infiltration, edema, and fibroblast proliferation in orbital tissues, can be present (Hiromatsu et al, 2014), while the chronic inactive phase is characterized by interstitial fibrosis with collagen deposition and fat infiltration (Gould et al, 2012). It was reported that TAO restricted patients’ daily activities and led to dysfunctions in social roles and impaired self-confidence associated with altered appearance (Zeng et al, 2019) The reality for these patients is that their eyes are stared at by strangers (Roos and Murthy, 2019), their identities are changed (Estcourt et al, 2008), and their social functions are disabled (Coulter et al, 2007). We believe that TAO may produce neuropathological changes that are responsible for patients’ neuropsychic dysfunctions

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