Widespread brain reorganization perturbs visuomotor coordination in early glaucoma
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Date
2019-10-02
Authors
Trivedi, Vivek
Bang, Ji Won
Parra, Carlos
Colbert, Max K.
O’Connell, Caitlin
Arshad, Ahmel
Faiq, Muneeb A.
Conner, Ian P.
Redfern, Mark S.
Wollstein, Gadi
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Abstract
Glaucoma is the world’s leading cause of irreversible blindness, and falls are a major public health
concern in glaucoma patients. Although recent evidence suggests the involvements of the brain toward
advanced glaucoma stages, the early brain changes and their clinical and behavioral consequences
remain poorly described. This study aims to determine how glaucoma may impair the brain structurally
and functionally within and beyond the visual pathway in the early stages, and whether these changes
can explain visuomotor impairments in glaucoma. Using multi-parametric magnetic resonance
imaging, glaucoma patients presented compromised white matter integrity along the central visual
pathway and around the supramarginal gyrus, as well as reduced functional connectivity between the
supramarginal gyrus and the visual occipital and superior sensorimotor areas when compared to healthy
controls. Furthermore, decreased functional connectivity between the supramarginal gyrus and the
visual brain network may negatively impact postural control measured with dynamic posturography
in glaucoma patients. Taken together, this study demonstrates that widespread structural and
functional brain reorganization is taking place in areas associated with visuomotor coordination in early
glaucoma. These results implicate an important central mechanism by which glaucoma patients may be
susceptible to visual impairments and increased risk of falls.