Abstract
BackgroundStrabismus is a disorder in which the eyes are misaligned. Persistent strabismus can lead to stereopsis impairment. The effect of strabismus on human brain is not unclear. The present study is to investigate whether the brain white structures of comitant exotropia patients are impaired using combined T1-weighted imaging and diffusion tensor imaging (DTI).Principal FindingsThirteen patients with comitant strabismus and twelve controls underwent magnetic resonance imaging (MRI) with acquisition of T1-weighted and diffusion tensor images. T1-weighted images were used to analyze the change in volume of white matter using optimized voxel-based morphology (VBM) and diffusion tensor images were used to detect the change in white matter fibers using voxel-based analysis of DTI in comitant extropia patients. VBM analysis showed that in adult strabismus, white matter volumes were smaller in the right middle occipital gyrus, right occipital lobe/cuneus, right supramarginal gyrus, right cingulate gyrus, right frontal lobe/sub-gyral, right inferior temporal gyrus, left parahippocampa gyrus, left cingulate gyrus, left occipital lobe/cuneus, left middle frontal gyrus, left inferior parietal lobule, and left postcentral gyrus, while no brain region with greater white matter volume was found. Voxel-based analysis of DTI showed lower fractional anisotropy (FA) values in the right middle occipital gyrus and right supramarginal gyrus in strabismus patients, while brain region with increased FA value was found in the right inferior frontal gyrus.ConclusionBy combining VBM and voxel-based analysis of DTI results, the study suggests that the dorsal visual pathway was abnormal or impaired in patients with comitant exotropia.
Highlights
Comitant strabismus is a common form of strabismus, which affects 1–4.2% of the population [1,2,3]
By combining voxel-based morphology (VBM) and voxel-based analysis of diffusion tensor imaging (DTI) results, the study suggests that the dorsal visual pathway was abnormal or impaired in patients with comitant exotropia
Our study aims to investigate the changes in white matter structure of the strabismus patients using optimized VBM and voxel-based analysis of DTI, which can help to elucidate the effect of early abnormal experience on the plasticity of human brain
Summary
Comitant strabismus is a common form of strabismus, which affects 1–4.2% of the population [1,2,3]. Comitant strabismus presents with stereopsis impairment, especially in those patients with onset in early childhood, whose stereopsis is substantially impaired. Stereopsis is still unrestored for many adults with early-onset and long-standing strabismus though they underwent strabismus surgery. These interesting phenomena may suggest that certain regions in the brain, the regions controlling stereopsis, may be affected by early abnormal visual experience. Previous studies have already suggested that brain plasticity changes can be induced by early abnormal viusal experience, such as strabismus. The present study is to investigate whether the brain white structures of comitant exotropia patients are impaired using combined T1-weighted imaging and diffusion tensor imaging (DTI)
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