Proton Magnetic Resonance Spectroscopy (1H-MRS) Reveals Geniculocalcarine and Striate Area Degeneration in Primary Glaucoma

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Abstract

Background

Glaucoma is a collection of neurodegenerative diseases that affect both the retina and the central visual pathway. We investigated whether metabolites' concentrations changed in the geniculocalcarine (GCT) and the striate area of occipital lobe by proton magnetic resonance spectroscopy ( ¹H-MRS), suggesting neurodegeneration of the central visual pathway in primary glaucoma.

Methodology/Principal Findings

20 patients with glaucoma in both eyes were paired with 20 healthy volunteers in same gender and an age difference less than 3 years. All the participants were examined by MR imaging including T ₁ Flair, T ₂ FSE and ¹H-MRS. The T ₁ intensity and T ₂ intensity of their GCTs and striate areas were measured. The ratio of N-acetylaspartate (NAA)/Creatine (Cr), Choline (Cho)/Cr, glutamine and glutamate (Glx)/Cr were derived by multi-voxels ¹H-MRS in the GCT and the striate area of each brain hemisphere. The T ₁ intensity and T ₂ intensity had no difference between the groups. Significant decreases in NAA/Cr and Cho/Cr but no difference in Glx/Cr was found between the groups in both the GCT and the striate area.

Conclusions/Significance

Primary glaucoma affects metabolites' concentrations in the GCT and the striate area suggesting there is ongoing neurodegenerative process.

Related collections

Most cited references 22

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The pathology of glaucoma has been extensively studied at the level of the retina and optic nerve head. Here the first clinicopathological case of human glaucoma is reported demonstrating degenerative changes in the brain involving the intracranial optic nerve, lateral geniculate nucleus, and visual cortex. Pathological evidence of neural degeneration in this patient is correlated with clinical, optic nerve head, visual field, and neuroradiology findings. Neuropathology in the glaucoma brain is compared to age matched controls. In the presence of advanced human glaucoma with 50% visual field loss, neural damage is evident in multiple vision stations within the brain.

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Chronic human glaucoma causing selectively greater loss of large optic nerve fibers.

H Quigley, Jason Dunkelberger, Ralph Green (1988)

Eighteen eyes of 12 persons with chronically elevated intraocular pressure (IOP) were studied histologically to determine the number and diameter of optic nerve fibers. In some eyes, automated perimetry had been performed. Optic nerve fibers larger than the mean diameter were killed more rapidly than smaller fibers, although no fiber size was completely spared at any stage of atrophy. The number of optic nerve fibers varies considerably among normal eyes. The authors confirmed that the death of a substantial proportion of optic nerve fibers precedes detectable visual field loss.

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Optic nerve and optic radiation neurodegeneration in patients with glaucoma: in vivo analysis with 3-T diffusion-tensor MR imaging.

Angelica Cerulli, Roberto Floris, Giovanni Simonetti … (2009)

To evaluate, with high-field-strength diffusion-tensor (DT) magnetic resonance (MR) imaging, the axonal architecture of the optic nerves and optic radiations in patients with glaucoma and determine whether DT MR imaging-derived parameters correlate with disease severity. The study was approved by the institutional review board. All participants provided written informed consent. Sixteen patients with primary open-angle glaucoma were examined. Glaucoma severity was clinically assessed with use of a six-stage system based on static threshold visual field parameters. Ten healthy individuals served as control subjects. DT MR imaging was performed with a 3-T MR unit. Mean diffusivity (MD) and fractional anisotropy (FA) maps were automatically created. Regions of interest were positioned on the MD and FA maps, and mean MD and mean FA values were calculated for each optic nerve and each optic radiation. The optic radiations and optic nerves of patients with glaucoma, as compared with control subjects, had significantly higher MD and significantly lower FA. The mean MD values for the optic nerves and the glaucoma stages varied consistently (r = 0.8087, P < .0001). A negative correlation between mean FA for the optic nerves and glaucoma stage (r = -0.7464, P < .0001) was observed. Glaucoma is a complex neurologic disease that affects optic nerves and optic radiations. The finding that DT MR imaging-derived MD and FA in the optic nerves correlate with glaucoma severity suggests that these parameters could serve as complementary indicators of disease severity.

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Author and article information

Contributors

Rafael Linden: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, USA )

ISSN (Electronic): 1932-6203

Publication date Collection: 2013

Publication date (Electronic): 29 August 2013

Volume: 8

Issue: 8

Electronic Location Identifier: e73197

Affiliations

[1 ]Zhongshan Ophthalmic Center, State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, GuangDong, China

[2 ]Department of Radiology, Nan Fang Hospital, Southern Medical University, Guangzhou, GuangDong, China

[3 ]Department of Ophthalmology, Nan Fang Hospital, Southern Medical University, Guangzhou, GuangDong, China

Universidade Federal do Rio de Janeiro, Brazil

Author notes

* E-mail: zxlnfyy@ 123456163.com

Competing Interests: The authors have declared that no competing interests exist.

Conceived and designed the experiments: XLZ YZ GJW GW XYC. Performed the experiments: XYC GW YZ GJW XLZ. Analyzed the data: YZ XYC XLZ GW GJW. Contributed reagents/materials/analysis tools: XYC YZ GW GJW XLZ. Wrote the paper: YZ XYC XLZ.

Article

Publisher ID: PONE-D-13-18516

DOI: 10.1371/journal.pone.0073197

PMC ID: 3756940

PubMed ID: 24009739

SO-VID: eb1d3bbe-9d45-40b6-9211-8b690df3f694

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 4 May 2013

Date accepted : 17 July 2013

Page count

Pages: 6

Funding

The authors have no support or funding to report.

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