Widespread Structural and Functional Brain Changes and Visuomotor Impairments in Glaucoma
Co-Principal InvestigatorsJoel Schuman, MD New York University Langone Medical Center
Glaucoma is the second leading cause of blindness worldwide, and falls are a major health concern in glaucoma patients. Recently, increasing evidence suggests that glaucoma is not an eye-only disease but also involves widespread changes in the brain; however, its causes and the potential clinical and behavioral effects on visuomotor function remain unclear. The goal of the project is to understand how glaucoma may impair the brain structurally and functionally within and beyond the visual pathway, and whether the brain changes in glaucoma are associated with early vision loss or balance and mobility impairments. The findings will improve our understanding of the mechanisms of visuomotor impairments in glaucoma and ultimately guide vision preservation and falls-related interventions to individual patients.
Our laboratory is investigating how glaucoma may impair the brain structurally and functionally, and whether the brain changes in glaucoma are associated with early vision loss or balance and mobility impairments in our patients. We are using the non-invasive magnetic resonance imaging (MRI) scanner to take pictures of different aspects of the brain in our patients, with an aim to detect and monitor the disease events, to identify early glaucoma mechanisms and eye-brain-behavior relationships, and to guide therapeutic strategies in the visual system, which may help reduce the burden of this leading cause of irreversible but preventable visual impairment. In addition, since falls are a major health concern in glaucoma patients, we are investigating the brain mechanisms of balance or mobility impairments in our patients in order to help identify patients at increased risk of falls, to develop and implement falls rehabilitation programs, and to monitor the impact of intervention measures on the mechanisms contributing to falls.
When the study is completed, this project will offer a non-invasive and optimized multi-modal visualization platform for determining the glaucoma pathophysiology in the brain for clinical and translational research. The improved understanding of the structural and functional brain changes that occur both along and beyond the visual pathway could expedite the development of early diagnosis and targeted interventions to improve visuomotor outcomes and help prevent falls in patients with this disease.