Dermatomal Mapping with Spinal Cord Functional Magnetic Resonance Imaging

使用脊髓功能磁共振成像进行皮区标测

• 批准号: 10720645
• 负责人: Kenneth Arnold Weber
• 金额: $ 58.79万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10720645
• 关键词: Acceleration; Affect; Age; Brain; Cervical Radiculopathies; Classification; Clinical; Clinical assessments; Cutaneous; Digit structure; Electromyography; Esthesia; Excision; Female; Functional Magnetic Resonance Imaging; Goals; Hand; Head and neck structure; Human; Image; Image Analysis; Individual; Inferior; Injury; Interdisciplinary Study; Knowledge; Left; Location; Magnetic Resonance Imaging; Maps; Methods; Monitor; Motor; Muscle Weakness; Nerve; Nervous System; Nervous System Trauma; Neuroanatomy; Neurologic Effect; Noise; Pain; Patients; Radiculopathy; Research; Resolution; Sensitivity and Specificity; Sensory; Severities; Sex Differences; Side; Signal Transduction; Site; Spatial Distribution; Spinal; Spinal Cord; Spinal Ganglia; Spinal nerve root structure; Spinal nerve structure; Stimulus; Surface; Testing; Uncertainty; Upper Extremity; Validation; Vertebral column; Work; age stratification; clinical examination; clinical practice; dermatome; diagnostic biomarker; diagnostic value; dorsal horn; experimental study; healthy volunteer; improved; in vivo; injured; irritation; machine learning algorithm; male; neural; novel; open source; physically handicapped; predictive marker; sensory stimulus; sex; spinal cord imaging; spinal cord mapping; tool

PROJECT SUMMARY/ABSTRACT Radiculopathy is a common spinal condition resulting from compression and irritation of the spinal nerve roots, leading to sensory deficits, muscle weakness, and pain. Dermatomal maps are a key component of the clinical exam and provide information on the correspondence between cutaneous sensations and the nervous system. Dermatomal sensory deficits can help localize neurological injury in spinal conditions and guide treatment. Dermatomal maps, however, are limited—they contain uncertainty in the neuroanatomy mapped (spinal nerve, dorsal root ganglion, dorsal horn, or spinal cord (SC) segment), assume left-right symmetry and no sex differences, provide no information on between-subject variability, and remain to be validated. SC functional magnetic resonance imaging (fMRI) permits the non-invasive in vivo spatial mapping of human SC activity. Here we will use SC fMRI to test hypotheses central to dermatomal maps, investigate the effects of neurological injury on SC sensory processing, develop markers of SC sensory activity, and test their diagnostic value in cervical radiculopathy while improving our SC fMRI methods. To accomplish this, we will first enhance our existing SC fMRI methods by building a research-grade 64-channel head-neck coil, testing a novel spatial normalization method that accounts for SC segment location, and exploring the use of surface electromyography to monitor and remove motor-related noise during fMRI experiments. We will compare the improved SC fMRI methods against our currently operational methods while characterizing the SC correlates of sensory stimulus intensity encoding using electrocutaneous sensory stimulation of the third digit of the right hand (C7 dermatome) in 30 healthy volunteers (HV) (20-79 years old, 15 females, 15 males). Then using the enhanced SC fMRI methods, we will quantitatively map the spatial distribution of SC activity in 120 right- handed HVs (20-79 years old, 60 females, 60 males, stratified by age) during electrocutaneous sensory stimulation of the first, third, and fifth digits (C6, C7, and C8 dermatomes, respectively) of the left and right hands. We will develop probabilistic maps of the spatial distribution of SC activity, assess the superior-inferior localization of activity, contrast the activity between left and right stimulation and sexes, and quantify between- subject variability. We will use machine learning algorithms to develop normative SC sensory markers by predicting the stimulation site. Finally, 40 right-handed patients with right-sided C7 cervical radiculopathy (30– 79 years old, 20 females, 20 males) and 40 age- and sex-matched HVs will also undergo the same SC fMRI experiment, and we will investigate group differences in SC activity to uncover the effects of neurological injury on SC sensory processing and then assess the diagnostic value of the SC sensory markers. Completing our aims will improve SC fMRI methods, validate/refute hypotheses central to dermatomal maps to better inform their use in clinical practice, advance our scientific knowledge of SC sensory processing in healthy and injured states, and provide preliminary validation of MRI-based diagnostic markers for cervical radiculopathy.

项目总结/摘要 神经根病是一种常见的脊柱疾病，由脊神经根的压迫和刺激引起， 导致感觉缺陷、肌肉无力和疼痛。皮节图是临床检查的关键组成部分， 检查并提供有关皮肤感觉和神经系统之间的对应关系的信息。 皮节感觉缺陷可以帮助定位脊柱疾病中的神经损伤并指导治疗。 然而，皮节图是有限的-它们包含映射的神经解剖学的不确定性（脊神经， 背根神经节、背角或脊髓（SC）节段），假定左右对称且无性别 差异，未提供受试者间变异性的信息，仍有待验证。SC泛函 磁共振成像（fMRI）允许人SC活性的非侵入性体内空间映射。 在这里，我们将使用SC功能磁共振成像来测试皮区图的核心假设，研究 神经损伤对SC感觉加工的影响，开发SC感觉活动的标志物，并测试其诊断 同时改进我们的SC fMRI方法。为了实现这一目标，我们将首先增强 我们现有的SC功能磁共振成像方法，通过建立一个研究级的64通道头颈线圈，测试一个新的空间 标准化方法，占SC段的位置，并探讨使用表面 在功能磁共振成像实验中，肌电图监测和消除与运动相关的噪音。我们将比较 针对我们目前的操作方法改进SC fMRI方法，同时表征SC相关性 感觉刺激强度编码使用电皮肤感觉刺激的第三个数字的权利 30名健康志愿者（HV）（20-79岁，女性15名，男性15名）手（C7皮区）。然后使用 增强的SC功能磁共振成像方法，我们将定量映射SC活动的空间分布在120右， 手HV（20-79岁，60名女性，60名男性，按年龄分层）在电皮肤感觉期间 刺激左侧和右侧的第一、第三和第五指（分别为C6、C7和C8皮区） 手我们将开发SC活动的空间分布的概率图，评估SC活动的上-下 活动的定位，对比左右刺激和性别之间的活动，并量化- 受试者变异性。我们将使用机器学习算法来开发规范的SC感觉标记， 预测刺激部位。最后，40例右利手的右侧C7颈椎神经根病患者（30- 79岁，20名女性，20名男性）和40名年龄和性别匹配的HV也将接受相同的SC fMRI 实验，我们将研究SC活性的组间差异，以揭示神经损伤的影响 对SC感觉加工的影响，然后评估SC感觉标记物的诊断价值。完成我们 目标将改善SC功能磁共振成像方法，验证/反驳皮区图的核心假设，以更好地了解 它们在临床实践中的应用，推进了我们对健康和受伤的SC感觉加工的科学知识， 国家，并提供初步验证的MRI为基础的诊断标志物的颈椎神经根病。