Binasal occlusion modulates cortical functional connectivity and hemodynamics in acquired paralytic esotropia: a fNIRS study
摘要
To investigate the hemodynamic responses and functional connectivity patterns in the visual cortex of patients with acquired brain injury-related esotropia (ABI-ESO) following Binasal Occlusion (BNO) using functional near-infrared spectroscopy (fNIRS). Patients who were diagnosed with ABI-ESO as the ABI-ESO group, and healthy controls were enrolled as the control group. fNIRS was used to monitor cerebral oxyhemoglobin (HbO) concentrations during a visual stimulation task (black-and-white checkerboard) before and after BNO. Changes in activation levels and functional connectivity among visual-related regions were analyzed. Baseline analysis revealed that the ABI-ESO group had significantly lower Occipital Eye Field (OEF) activation and weaker functional connectivity compared to controls. Following BNO, we observed distinct cortical changes. Specifically, the ABI-ESO group exhibited increased activation in the left Parietal Eye Field (LPEF). In terms of functional connectivity, coupling strength decreased in the inter-hemispheric pathways between bilateral Frontal (LFEF–RFEF) and Parietal (LPEF–RPEF) Eye Fields post-intervention in the ABI-ESO group, suggesting a reorganization of the visual network. ABI-ESO is characterized by baseline cortical hypo-activity and network disruption. BNO therapy facilitates dorsal stream activity and modulates inter-hemispheric connectivity by suppressing maladaptive synchronization. These findings suggest that BNO functions as a neuro-modulatory intervention, offering a preliminary objective rationale for neuro-visual rehabilitation.