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Abnormal developmental trends of functional connectivity in young children with infantile esotropia
Jianlin Guo1, Yuanyuan Chen2, Wen Liu3
1Department of Radiology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
Insights
Infantile esotropia (IE) patients show abnormal brain functional connectivity from birth, with critical developmental changes occurring between 3-4 years. Early intervention may help normalize brain network development in children with IE.
Area of Science:
- Neuroscience
- Developmental Neuroscience
- Pediatric Ophthalmology
Background:
- Functional brain networks are present at birth and evolve through early childhood.
- The developmental trajectory of functional connectivity in infantile esotropia (IE) remains poorly understood.
Purpose of the Study:
- To investigate developmental trends in functional brain connectivity in children with IE.
- To identify critical periods for brain network development in IE patients.
Main Methods:
- Resting-state functional magnetic resonance imaging (fMRI) was used to analyze whole-brain functional network connectivity.
- 17 patients with IE and 20 healthy controls were studied.
- General linear models and quadratic parabolic models assessed group-age interactions and connectivity discrepancies.
Main Results:
- Significant group-age interactions were found in connectivity between visual, default mode, and sensorimotor networks, as well as within the limbic network.
- A U-shaped difference in functional connectivity trajectories between IE patients and controls emerged, with an inflection point between 3.1 and 4.0 years.
- Abnormal functional connectivity in IE may originate at birth, impacting visual processing and potentially leading to IE pathogenesis.
Conclusions:
- Infantile esotropia is associated with abnormal functional brain network development from birth.
- The period between 3 and 4 years of age represents a critical window for establishing normal brain network connections in children with IE.
- Early surgical intervention during this critical window may facilitate more typical brain development in children with IE.
Abstract:
Previous studies have shown that functional networks are present at birth and change dynamically throughout infancy and early childhood. However, the status of functional connectivity is still poorly understood in patients with infantile esotropia (IE). The aim of this study is to investigate the developmental trends of functional connectivity in patients with IE during a critical period of growth and development. A total of 17 patients with IE (9 males and 8 females; mean age: 3.36 ± 2.03 years, age range: 0.67-6.36 years) and 20 healthy subjects matched for age and gender were recruited and underwent resting-state functional magnetic resonance imaging. The whole-brain functional network connectivity was analyzed for the IE group and healthy control group. A general linear model was applied to assess the group-age interaction in terms of the functional connectivity. The discrepancy between the two groups in functional connectivity trajectories was also quantified across age and exhibited by the quadratic parabolic model. There were significant group-age interactions between the visual network and the default mode network, the visual network and the sensorimotor network, the limbic network and the default mode network, and within the limbic network in the functional connectivity. A U-shaped tendency across age, with an "inflection point" ranging from 3.1 to 4.0 years of age was exhibited in the difference between functional connectivity trajectories of the IE patients and normal controls. Abnormality in functional network connectivity could present in IE patients at birth, exhibiting aberrant developmental patterns over time. An abnormal functional network could reduce the ability of the cortex in visual information processing, further reactivating the subcortical visual information processing system, which is probably the pathogenesis of IE. Three to four years after birth is the critical time window for children with IE to establish normal network connections in the brain. Early surgery during this period may be helpful for affected children to have an opportunity to approach the normal development trajectory as early as possible.
