Cortical morphometric changes after spinal cord injury
Cortical morphometric changes after spinal cord injury
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DOI：
10.1016/j.brainresbull.2017.11.013
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发表时间：
2018-03-01
影响因子：
3.8
通讯作者：
Trinka, Eugen
中科院分区：
文献类型：
--
作者：
Nardone, Raffaele;Hoeller, Yvonne;Trinka, Eugen
神经影像学研究表明，脊髓损伤（SCI）可能会导致人类感觉运动系统的显着解剖学改变。特别是，基于体素的形态学（VBM）的皮质体积显示了显着的灰色和白色物质萎缩双侧初级感觉皮质（S1）。相比之下，一些结构研究未能检测到SCI后初级运动皮层（Ml）中灰质体积（GMV）的变化，而其他研究则报道了Ml中GMV的显著降低。除了感觉运动皮层的直接变性外，SCI还可导致非感觉运动皮层的萎缩，如前扣带回、岛叶皮层、额中回和辅助运动区。这些发现表明，脊髓损伤可导致远端的脑灰质萎缩的显着网络。此外，疼痛相关的重塑可能发生在SQ。事实上，SCI的结构变化也与下层疼痛的存在和程度有关，我们对SCI患者的神经影像学研究进行了系统的回顾，这些研究显示了形态学的皮层变化和随后的功能重组。使用PubMed和Embase进行文献检索。我们确定了12篇符合纳入标准的文章，195例患者被纳入这些研究。疾病持续时间、康复训练、药物干预和不同研究方法的广泛范围，特别是感兴趣区域的确定和校正多重比较的统计方法，可能导致了所审查研究之间的一些不一致。然而，神经影像学生物标志物可以评估神经损伤的程度，阐明神经修复的机制，并预测临床结果。更好地了解SCI后皮质水平发生的结构和功能变化可能有助于跟踪潜在的治疗诱导的变化和识别潜在的治疗靶点，从而开发循证康复治疗。
Neuroimaging studies suggest that spinal cord injury (SCI) may lead to significant anatomical alterations in the human sensorimotor system. In particular, voxel-based morphometry (VBM) of cortical volume has revealed a significant gray and white matter atrophy bilaterally in the primary sensory cortex (S1). By contrast, some structural studies failed to detect changes in gray matter volume (GMV) in the primary motor cortex (Ml) following SCI, whereas others have reported a substantial decrease of GMV also in Ml. In addition to direct degeneration of the sensorimotor cortex, SCI can also lead to atrophy of the non-sensorimotor cortex, such as anterior cingulate cortex, insular cortex, middle frontal gyrus and supplementary motor area. These findings suggest that SCI can cause remote atrophy of brain gray matter in the salient network. Furthermore, pain-related remodelling may occur in SQ. In fact, structural changes in SCI are also related to the presence and degree of below-level pain.We performed a systematic review of the neuroimaging studies showing morphometric cortical changes and subsequent functional reorganization in humans with SCI. Literature search was conducted using PubMed and Embase. We identified 12 articles matching the inclusion criteria and 195 patients were included in these studies. The wide range of disease duration, rehabilitation training, drug intervention, and different research methodology, especially the identification of region of interest and the statistical approach to correct for multiple comparisons, may have contributed to some inconsistencies between the reviewed studies. Nevertheless, neuroimaging biomarkers can assess the extent of neural damage, elucidate the mechanisms of neural repair, and predict clinical outcome. A better understanding of the structural and functional changes that occur at cortical level following SCI may be useful in tracking potential treatment induced changes and identifying potential therapeutic targets, thus developing evidence-based rehabilitation therapies.