Glaucoma patients have a high incidence of sleep disorders. This relationship implies that glaucoma may involve alterations in sleep-regulating systems. Here, we examined how glaucoma affects sleep-regulating subcortical systems. In particular, we focused on the ventrolateral preoptic nucleus (VLPO), a central sleep-inducing hub. We demonstrated that glaucoma patients had altered functional connectivity of VLPO with the subcortical arousal system and the occipital cortex. We also showed that glaucoma patients had reduced GABA levels in the occipital cortex. Overall, our study suggests that sleep-regulating subcortical structures involving VLPO and their inhibitory projections to the cortex are impaired in glaucoma.
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