Abstract

Background: Changes in regional neural activity and functional connectivity in cervical spondylotic myelopathy (CSM) patients have been reported. However, resting-state cerebral blood flow (CBF) changes and coupling between CBF and functional connectivity in CSM patients are largely unknown.Methods: Twenty-seven CSM patients and 24 sex/age-matched healthy participants underwent resting-state functional MRI and arterial spin labeling imaging to compare functional connectivity strength (FCS) and CBF between the two groups. The CBF–FCS coupling of the whole gray matter and specific regions of interest was also compared between the groups.Results: Compared with healthy individuals, CBF–FCS coupling was significantly lower in CSM patients. The decrease in CBF–FCS coupling in CSM patients was observed in the superior frontal gyrus, bilateral thalamus, and right calcarine cortex, whereas the increase in CBF–FCS coupling was observed in the middle frontal gyrus. Moreover, low CBF and high FCS were observed in sensorimotor cortices and visual cortices, respectively.Conclusion: In general, neurovascular decoupling at cortical level may be a potential neuropathological mechanism of CSM.

Highlights

  • Cervical spondylotic myelopathy (CSM) is a common degenerative spinal cord complication that results in significant mortalities [1,2,3]

  • In subject-level analysis, the correlation coefficients between the cerebral blood flow (CBF) map and Functional Connectivity Strength (FCS) map across whole gray matter voxels were compared between CSM patients and healthy controls

  • To the best of our knowledge, this is the first study investigating CBF–FCS coupling changes in CSM patients using a combination of blood oxygenation level-dependent (BOLD) and arterial spin labeling (ASL) techniques

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Summary

Introduction

Cervical spondylotic myelopathy (CSM) is a common degenerative spinal cord complication that results in significant mortalities [1,2,3]. Increasing evidence shows that CSM is linked to the altered structure [5] and function [6,7,8,9,10,11] of the brain. Functional MRI (fMRI), a blood-oxygenlevel-dependent signal, measures the spontaneous neural activity of the brain. Assessment of functional alterations in CSM patients relies on regional homogeneity (ReHo), amplitude of low frequency fluctuation (ALFF), and functional connectivity (FC). Changes in regional neural activity and functional connectivity in cervical spondylotic myelopathy (CSM) patients have been reported. Resting-state cerebral blood flow (CBF) changes and coupling between CBF and functional connectivity in CSM patients are largely unknown

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