# Cerebellar dysfunction in glaucoma patients

## TL;DR

Glaucoma patients show changes in cerebellar brain connections that may explain their higher risk of falls and balance issues.

## Contribution

This study reveals cerebellar and cerebro-cerebellar functional connectivity changes in glaucoma patients.

## Key findings

- Functional connectivity within the cerebellum was weakened in glaucoma patients.
- Functional connectivity between cerebral and cerebellar regions showed opposite changes in glaucoma patients.
- These changes suggest cerebellar dysfunction may underlie impaired balance in glaucoma.

## Abstract

Glaucoma patients often have higher injurious fall rates compared to healthy older adults. However, little is known about the underlying neural mechanisms. Recent evidence shows cerebral changes beyond the visual pathway of glaucoma patients, yet it remains unclear whether the cerebellum, which plays an important role in balance and motor control, is involved in glaucoma. In this study, we sought to investigate cerebellar functional connectivity changes in glaucoma by comparing 32 glaucoma subjects and 10 age-matched healthy control subjects who underwent resting-state functional magnetic resonance imaging at 3 Tesla with eyes closed. After conducting both regions-of-interest and seed-to-voxel analyses, we found that the functional connectivity within the cerebellum tended to be weakened in glaucoma patients compared to healthy controls, whereas the functional connectivity between some cerebral and cerebellar regions showed opposite changes in the same glaucoma subjects. Our findings underscore the potential role of cerebellar and cerebro-cerebellar dysfunction in postural and cognitive control in glaucoma patients. Taken together, these observations implicate the widespread brain changes in glaucoma beyond the cerebral regions into the cerebellum that may underlie the neural underpinnings of impaired balance control in this disease.

Kasi et al. report that glaucoma patients possessed weakened functional connectivity within the cerebellum compared to healthy controls, whereas that between some cerebral and cerebellar regions showed opposite changes in the same subjects. These observations implicate the widespread brain changes that may underpin the impaired balance control in glaucoma.

Graphical Abstract