斜视患者脑功能与结构异常的研究进展

斜视是一种常见的眼球运动障碍,表现为眼位偏斜,常伴双眼视觉功能受损。正常眼位有赖于参与视觉系统和眼球运动系统的各脑区的正常功能和它们之间的协调配合,其中任一层次的受损都可能引起斜视。早期神经电生理和免疫自显影技术应用于动物实验,发现初级视觉皮层功能损伤,包括双眼视神经元减少、眼优势柱代谢改变。近年来,功能磁共振的发展促进了对人脑皮层功能变化的认识。研究发现斜视患者不仅存在与眼球运动及双眼视觉功能障碍相关的脑皮层及皮层间联系的损伤,还存在与代偿相关的可塑性改变。而基于体素的形态计量学和弥散张量成像技术的应用为斜视患者大脑异常提供了解剖学依据。本文从脑功能与结构异常角度对近几年有关斜视神经机制的研究进展进行综述,以期为进一步研究提供参考。

Research progress on the abnormal brain structure and function of patients with strabismus

Strabismus is a common type of eye movement disorders, which is characterized by ocular misalignment and binocular visual dysfunction. Alignment relies on the normal structure and function of the visual and oculomotor systems. Any abnormalities of these regions may lead to strabismus. With the application of neurophysiological techniques and radioautography in the early years, the impairment of primary visual cortex was found, including decreased number of binocular neurons and metabolic changes of ocular dominant column. In recent years, the progress of functional magnetic resonance imaging has promoted to find more functional changes in human strabismic brains, especially in extrastriate cortex. In addition to the structural impairment of cerebral cortex and intercortical connections, functional remodeling of cerebral cortex was also observed in patients with strabismus. Besides, studies based on voxel-based morphometry and diffusion tensor imaging provided more precise anatomical evidence for human brain abnormalities. To provide reference for further studies, we review the current literature on functional and morphological deficits within brain regions in strabismus.