Linked Distinct Multi-modular Brain Connectivity Patterns with Retina Microvascular and Structural Alterations, and Their Correlations with Visual Performance in Thalamic Stroke

Abstract The neuro-ophthalmologic symptoms and retinal changes have been increasingly noticed after thalamic stroke and increasing evidence showing distinct alterations occurred in the vision-related functional network, while their intrinsic correlations are not completely understood. We aimed to explore the altered of functional network linking patterns and retina parameters, and their correlations with visual performance in thalamic stroke patients. Multi-modular functional connectivity (FC) was obtained with resting-state functional MRI. Optical coherence tomography-angiography was used to obtain retina parameters (retinal nerve fiber layer, RNFL; ganglion cell-inner plexiform layer, GCIP; superficial vascular complex, SVC; and deep vascular complex, DVC). Visual performance was measured through visual acuity (VA). Forty-six patients with first-ever unilateral thalamic stroke (mean age 59.74 ± 10.02 years, 33 males) were included. Significant associations were found in FC of Attention-to-Default Mode with SVC, RNFL, and GCIPL, and in FC of Attention-to-Visual with RNFL (p < 0.05). Both RNFL and GCIPL were significantly associated with the FC of Visual-to-Visual (p < 0.05). Only GCIPL was associated with VA (p = 0.038). In stratified analysis based on the disease duration of 6-month, distinct and significant linking patterns were displayed in muti-modular FC and various certain retina parameters; and their correlations with VA varied in each subgroup, respectively. These findings provide new insight into the understanding of the neural basis of the associations between brain network dysfunction and impaired visual performance in patients with thalamic stroke. Our findings are novel and might benefit targeted and individualized therapies in the future. Further in-depth studies are needed to verify our results.