Tactile-associated recruitment of the cervical cord is altered in patients with multiple sclerosis
Tactile-associated recruitment of the cervical cord is altered in patients with multiple sclerosis
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DOI：
10.1016/j.neuroimage.2007.10.048
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发表时间：
2008-02-15
期刊：
影响因子：
5.7
通讯作者：
Filippi, Massimo
中科院分区：
文献类型：
--
作者：
Agosta, Federica;Valsasina, Paola;Filippi, Massimo
大脑功能磁共振成像 (fMRI) 研究表明，皮质重组可能有助于多发性硬化症 (MS) 获得更有利的临床结果。为了评估功能磁共振成像的变化是否也可以在多发性硬化症患者的脊髓中检测到，并调查其性质和程度，在右手手掌的触觉刺激过程中对 25 名患者和 12 名匹配的健康对照进行了扫描。计算颈髓内所有激活体素的与任务相关的平均信号变化，并分别计算从 C5 到 C8 的右和左前、右和左后以及中颈髓。还测量了脊髓损伤数量、脑T2加权损伤负荷、灰质平均扩散率(MD)、以及正常出现的白质MD和各向异性分数。由于运动伪影，一名对照者和一名患者在功能磁共振成像分析之前被排除。所有脊髓激活体素的任务相关信号变化对于对照组为 3.2% (SD=0.8)，对于 MS 患者为 3.9% (SD=0.9) (p=0.02)。与对照组相比，MS 患者在以下脊髓部分显示出更高的信号变化：C5 的右前部 (p=0.05)、C6 的右前部 (p=0.04) 和后部 (p = 0.04)、C6 的中部 (p = 0.03) 和 C7/C8 (p = 0.01)。 MS 患者的左后颈髓 C5/C6 处的脊髓活动比对照组更频繁 (p=0.02)。脊髓 fMRI 变化与脑结构 MRI 指标之间没有发现显着相关性。在多发性硬化症患者中，同侧后颈髓的过度募集与功能侧化减少相关，表明脊髓中继中间神经元的功能异常。 (C) 2007 Elsevier Inc. 保留所有权利。
Functional magnetic resonance imaging (fMRI) studies of the brain have shown that cortical reorganization might contribute to a more favourable clinical outcome of multiple sclerosis (MS). In order to assess whether fMRI changes can also be detected in the spinal cord from patients with MS, and to investigate their nature and extent, twenty-five patients and 12 matched healthy controls were scanned during a tactile stimulation of the palm of the right hand. The task-related mean signal change was computed for all activated voxels within the cervical cord and, separately, in the right and left anterior, right and left posterior, and middle cervical cord from C5 to C8. Cord lesion number, brain T2-weighted lesion load, gray matter mean diffusivity (MD), and normal appearing white matter MD and fractional anisotropy were also measured. One control and one patient were excluded prior to fMRI analysis due to motion artifacts. The task-related signal change of all cord activated voxels was 3.2% (SD=0.8) for controls and 3.9% (SD=0.9) for MS patients (p=0.02). Compared with controls, MS patients showed a higher signal change in the following cord sections: right anterior at C5 (p=0.05), right anterior (p=0.04) and posterior (p = 0.04) at C6, and middle at C6 (p = 0.03) and C7/C8 (p = 0.01). MS patients showed a more frequent cord activity in the left posterior cervical cord at C5/C6 than controls (p=0.02). No significant correlation was found between cord fMRI changes and brain structural MRI metrics. In MS patients, the over-recruitment of the ipsilateral posterior cervical cord associated to a reduced functional lateralization suggests an abnormal function of the spinal relay interneurons. (C) 2007 Elsevier Inc. All rights reserved.