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Progressive visual loss in Retinitis Pigmentosa leads to cortical and subcortical reorganization of the human brain
Author(s) -
PEREIRA AC,
FERREIRA S,
QUENDERA B,
MATEUS C,
SILVA E,
CASTELOBRANCO M
Publication year - 2014
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2014.3671.x
Subject(s) - retinitis pigmentosa , medicine , cuneus , occipital lobe , visual cortex , cortical blindness , magnetic resonance imaging , retinal , ophthalmology , psychology , neuroscience , functional magnetic resonance imaging , precuneus , radiology , blindness , optometry
Purpose Retinitis Pigmentosa (RP) is a retinal disease characterized by photoreceptor degeneration. Usually, symptoms are early onset night blindness followed by progressive peripheral vision loss, with central vision being later affected. Some patients become blind after several years of disease. We studied the consequences of this progressive loss of visual input in the human brain using Magnetic Resonance Imaging. Methods 13 RP patients (8M, 5F; mean age 47±13yrs; range:23‐66yrs) and 24 age‐matched controls (10M, 14F; mean age 44±13yrs; range 22‐69yrs) were scanned in a 3T Siemens scanner. Cortical thickness (CT), surface area (SA) and subcortical volumes were obtained with Freesurfer. Results Patients’ visual field ranged from 22deg to almost blindness. Self‐reported symptoms’ onset ranged from birth to 45 years of age (mean symptoms’ duration: 30yrs; range 6‐51). Patients showed decreased CT in pericalcarine(p=0.002); cuneus(p<0.001); lingual(p=0.02) and lateral occipital(p=0.007) regions and increased CT in supramarginal(p=0.02), superior frontal(p=0.02) and the parahippocampal(p=<0.02) gyri. Also, cortical SA was decreased only in superior parietal cortex(p<0.009,) and increased in inferior temporal gyrus(p=0.03), isthmus cingulate(p=0.02), banks of superior temporal sulcus(p=0.007), pars orbitalis(p=0.02) and transverse temporal sulcus(p=0.002). Also, the caudate nucleus was increased in RP(p=0.003). Conclusion We conclude that visual input deprivation in RP leads to a large scale subcortical and cortical reorganization of brain resources, with loss in visual processing areas and changes in multimodal integration areas that may compensate for this sensory input loss.