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Altered spontaneous cortical activity in mild glaucoma: A quantitative EEG study.

Rupesh Samanchi1, Suriya Prakash Muthukrishnan1, Tanuj Dada2

  • 1Stress and Cognitive Electroimaging Laboratory, Department of Physiology, All India Institute of Medical Sciences, New Delhi, India.

Neuroscience Letters
|June 11, 2021
PubMed
Summary

Glaucoma, a neurodegenerative disease, shows altered brain activity even in early stages. This study found significant cortical changes in both primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) patients compared to controls.

Keywords:
Cortical activityPhysiological alterationsPrimary angle closure glaucomaPrimary open angle glaucomaQuantitative EEG

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Medical Imaging

Background:

  • Glaucoma is increasingly recognized as a progressive neurodegenerative disease affecting the optic nerve and potentially the brain.
  • Previous functional neuroimaging studies suggest cortical alterations in glaucoma, but early-stage, treatment-naive patients require further investigation.

Purpose of the Study:

  • To investigate cortical activity using high-density electroencephalography (EEG) in treatment-naive patients with mild primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG) during resting state.
  • To compare cortical activity patterns between POAG, PACG, and healthy controls.

Main Methods:

  • Acquisition of resting-state EEG data (eyes closed and eyes open) from 37 POAG, 34 PACG, and 32 healthy controls using a 128-channel system.
  • Preprocessing of EEG data and estimation of cortical current density using standardized low-resolution electromagnetic tomography (sLORETA) across 6239 voxels.

Main Results:

  • Patients with PACG showed increased activity in specific frontal and cingulate regions during eyes open condition compared to controls.
  • POAG patients exhibited significantly higher cortical activity in precentral and frontal gyri during eyes closed, and widespread alterations across multiple cortical regions during eyes open.
  • POAG patients demonstrated greater cortical activity in the precuneus and cuneus compared to PACG patients during eyes open. Intraocular pressure and visual field mean deviation positively correlated with cortical activity.

Conclusions:

  • Early-stage glaucoma involves significant physiological alterations in cortical activity, extending beyond retinal damage.
  • Cortical involvement is more pronounced in POAG than PACG, suggesting differential disease mechanisms or progression.
  • Managing intraocular pressure alone may be insufficient for glaucoma treatment due to the widespread nature of observed cortical alterations.