Assessing the spatial distribution of cervical spinal cord activity during tactile stimulation of the upper extremity in humans with functional magnetic resonance imaging
Assessing the spatial distribution of cervical spinal cord activity during tactile stimulation of the upper extremity in humans with functional magnetic resonance imaging
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DOI：
10.1016/j.neuroimage.2020.116905
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发表时间：
2020-05
期刊：
影响因子：
5.7
通讯作者：
K. Weber;Yufen J. Chen;Monica Paliwal;C. Law;Benjamin S. Hopkins;S. Mackey;Y. Dhaher;T. Parrish;Z. Smith
中科院分区：
文献类型：
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作者：
K. Weber;Yufen J. Chen;Monica Paliwal;C. Law;Benjamin S. Hopkins;S. Mackey;Y. Dhaher;T. Parrish;Z. Smith
皮区图是临床实践的支柱，提供有关脊神经皮肤神经支配空间分布的信息。皮肤缺损可以帮助隔离脊柱疾病中脊神经根受累的水平，并指导临床医生进行诊断和治疗。然而，皮肤图有其局限性，人类脊髓感觉活动的空间分布仍有待定量评估。在这里，我们使用脊髓功能性 MRI 来绘制和定量比较健康人（n = 24，年龄= 36.8 ± 11.8 岁）左右肩外侧（即 C5 皮节）和手背第三指（即 C7 皮节）触觉刺激期间感觉脊髓活动的空间分布。基于处理无害触觉感觉信息的中心位点，我们假设该活动将更多地定位于同侧背侧脊髓，而外侧肩部刺激活动比背侧第三指更定位。研究结果表明，左侧和右侧刺激在同侧半索中具有更多激活，从而导致活动偏侧化。与我们的假设相反，两个刺激部位的活动分布在背侧和腹侧半索，并且没有表现出明显的上下定位。相反，两种刺激的活动分布比预期更广泛，延伸到 C5、C6 和 C7 脊髓节段。我们强调了人类脊髓神经解剖学的复杂性以及可能解释观察到的活动模式的几个变异来源。虽然研究结果与我们的先验假设并不完全一致，但这项研究为继续工作奠定了基础，并且是朝着开发感觉功能的规范性定量脊髓测量方法迈出的重要一步，这可能成为有用的基于 MRI 的神经损伤客观生物标志物，并改善脊柱疾病的治疗。
Dermatomal maps are a mainstay of clinical practice and provide information on the spatial distribution of the cutaneous innervation of spinal nerves. Dermatomal deficits can help isolate the level of spinal nerve root involvement in spinal conditions and guide clinicians in diagnosis and treatment. Dermatomal maps, however, have limitations, and the spatial distribution of spinal cord sensory activity in humans remains to be quantitatively assessed. Here we used spinal cord functional MRI to map and quantitatively compare the spatial distribution of sensory spinal cord activity during tactile stimulation of the left and right lateral shoulders (i.e. C5 dermatome) and dorsal third digits of the hands (i.e., C7 dermatome) in healthy humans (n = 24, age = 36.8 ± 11.8 years). Based on the central sites for processing of innocuous tactile sensory information, we hypothesized that the activity would be localized more to the ipsilateral dorsal spinal cord with the lateral shoulder stimulation activity being localized more superiorly than the dorsal third digit. The findings demonstrate lateralization of the activity with the left- and right-sided stimuli having more activation in the ipsilateral hemicord. Contradictory to our hypotheses, the activity for both stimulation sites was spread across the dorsal and ventral hemicords and did not demonstrate a clear superior-inferior localization. Instead, the activity for both stimuli had a broader than expected distribution, extending across the C5, C6, and C7 spinal cord segments. We highlight the complexity of the human spinal cord neuroanatomy and several sources of variability that may explain the observed patterns of activity. While the findings were not completely consistent with oura priorihypotheses, this study provides a foundation for continued work and is an important step towards developing normative quantitative spinal cord measures of sensory function, which may become useful objective MRI-based biomarkers of neurological injury and improve the management of spinal disorders.