Postoperative Changes in Resting State Functional Connectivity and Clinical Scores in Patients With Cervical Myelopathy
Postoperative Changes in Resting State Functional Connectivity and Clinical Scores in Patients With Cervical Myelopathy
复制标题
DOI：
10.1016/j.wneu.2022.09.030
复制
发表时间：
2022-11-01
影响因子：
2
通讯作者：
Yamazaki, Masashi
中科院分区：
文献类型：
--
作者：
Eto, Fumihiko;Inomata, Kento;Yamazaki, Masashi
目的：静息态功能磁共振成像（rs-fMRI）是一种用于分析静息状态下解剖学上相距较远的脑区之间的功能连接（FC）的技术。本研究的目的是分析压迫性颈椎病患者术后FC的变化，以评估其与临床评分的关系，并检查与脑networks.METHODS相关的脊髓功能的变化：这项前瞻性研究包括15例颈椎病谁接受了计划的手术。术前和术后6个月采用类似方案进行RS-fMRI。通过日本骨科协会（乔亚）评分、日本骨科协会颈椎病评估问卷（JOACMEQ）和数字评定量表（NRS）评估临床功能。我们进行了基于种子的分析，并确定了手术后发生显著变化的网络。结果：术后5例FC明显增加，4例位于感觉运动网络（SMN）与其他区域之间。我们观察到右侧SMN和左侧中央前回的FC与乔亚评分、左侧SMN与上肢功能的JOACMEQ评分、左侧中央后回与NRS评分之间存在显著相关性。此外，FC的每个变化与临床评分显著相关，从而表明脊髓功能的恢复与感觉运动皮层的可塑性变化之间存在关联。
OBJECTIVE: Resting state functional magnetic resonance imaging (rs-fMRI) is a technique for the analyzing functional connectivity (FC) between anatomically distant brain regions at rest. The purpose of this study was to analyze postoperative FC changes in patients with compression cervical myelopathy, to evaluate their relationship with clinical scores, and to examine the changes in spinal cord function associated with brain networks.METHODS: This prospective study comprised 15 patients with cervical myelopathy who underwent planned surgery. Rs-fMRI was performed preoperatively and 6 months postoperatively with the similar protocol. Clinical function was assessed by the Japanese Orthopedic Association (JOA) score, the Japanese Orthopedic Association Cervical Myelopathy Evaluation Questionnaire (JOACMEQ), and the numerical rating scale (NRS). We performed a seed-based analysis, and identified the networks that changed significantly following surgery. Furthermore, we performed a correlation analysis to compare the postoperative changes in FC with clinical scores.RESULTS: Five FCs were significantly increased postoperatively; 4 were between the sensorimotor network (SMN) and other regions. We observed a significant correlation between the FC of the right SMN and the left precentral gyrus with the JOA score, the left SMNwith the JOACMEQ for upper extremity function, and the left postcentral gyrus with theNRS.CONCLUSIONS: The reorganization of the sensorimotor cortex occurred postoperatively in patientswith compression cervical myelopathy. In addition, each change in FC was significantly correlated with the clinical scores, thus indicating an association between the recovery of spinal cord function and plastic changes in the sensorimotor cortex.