Morphological and microstructural brain changes in thyroid-associated ophthalmopathy: a combined voxel-based morphometry
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ORIGINAL ARTICLE
Morphological and microstructural brain changes in thyroid‑associated ophthalmopathy: a combined voxel‑based morphometry and diffusion tensor imaging study Q. Wu1 · H. Hu1 · W. Chen1 · H.‑H. Chen2 · L. Chen1 · X.‑Q. Xu1 · F.‑Y. Wu1 Received: 3 February 2020 / Accepted: 28 March 2020 © Italian Society of Endocrinology (SIE) 2020
Abstract Purpose To explore the morphological and microstructural changes of grey and white matter in the patients of thyroidassociated ophthalmopathy (TAO). Methods Twenty-five TAO patients and 25 well-matched healthy controls were recruited. Structural T1- and diffusionweighted magnetic resonance imaging data were analyzed using voxel-based morphometry and voxel-based analysis of diffusion tensor imaging. Results Compared with healthy controls, TAO group showed significantly decreased grey matter volume in the brain region of the right middle frontal gyrus. Meanwhile, TAO group showed significantly decreased fractional anisotropy (FA), but increased mean, axial and radial diffusivities in the brain regions of the right superior occipital gyrus, middle occipital gyrus and cuneus in TAO group. In addition, the FA value in significant brain regions showed a positive correlation with visual acuity (r = 0.456, P = 0.025) and a negative correlation with disease duration (r = − 0.609, P = 0.003). Conclusion Significant morphological and microstructural abnormalities in areas corresponding to known functional deficits of vision and cognition could be found in TAO patients. These results extended our understanding of neural relationships with TAO. Keywords Thyroid-associated ophthalmopathy · Voxel-based morphometry · Diffusion tensor imaging · Vision · Cognition
Introduction Thyroid-associated ophthalmopathy (TAO) is an autoimmune inflammatory orbital disease. It occurs in 40–50% patients with Graves’ disease, and in 2–5% patients with immune thyroiditis [1, 2]. The initial complaint of TAO patients are the ophthalmic symptoms, including proptosis, redness of sclera, eyelids retraction and diplopia [3, Q. Wu, H. Hu and W. Chen contributed equally to this work. * X.‑Q. Xu [email protected] * F.‑Y. Wu [email protected] 1
Department of Radiology, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Gulou District, Nanjing, China
Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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4]. Besides that, TAO patients also frequently suffer from various emotional and psychological abnormalities, such as depression, anxiety, memory impairment and lack of concentration [5, 6]. These psychological disturbances would reduce patients’ quality of life and presumably, which might be related to the functional and structural changes in the brain [3, 5, 6]. However, few studies have focused on this issue by neuroimaging methods. Voxel-based morphometry (VBM) is an automated tool which is based on high-resolution T1-weighted imaging [7]. It provides whole brain analysis of intergrou
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