Abstract
Several neuroimaging studies have suggested brain reorganisation in patients with cervical spondylotic myelopathy (CSM); however, the changes in spontaneous neuronal activity that are associated with connectedness remain largely unknown. In this study, functional connectivity strength (FCS), a data-driven degree centrality method based on a theoretical approach, was applied for the first time to investigate changes in the sensory-motor network (SMN) at the voxel level. Comparatively, CSM not only showed significantly decreased FCS in the operculum-integrated regions, which exhibited reduced resting-state functional connectivity (rsFC) around the Rolandic sulcus, but it also showed increased FCS in the premotor, primary somatosensory, and parietal-integrated areas, which primarily showed an enhanced rsFC pattern. Correlation analysis showed that altered FCS (in the left premotor-ventral/precentral-operculum, right operculum-parietale 4, and right S1) was associated with worsening Japanese Orthopaedic Association scores and that the rsFC pattern was influenced by cervical cord micro-structural damage at the C2 level. Together, these findings suggest that during myelopathy, the intrinsic functional plasticity of the SMN responds to the insufficient sensory and motor experience in CSM patients. This knowledge may improve our understanding of the comprehensive functional defects found in CSM patients and may inspire the development of new therapeutic strategies in the future.
Highlights
Several neuroimaging studies have suggested brain reorganisation in patients with cervical spondylotic myelopathy (CSM); the changes in spontaneous neuronal activity that are associated with connectedness remain largely unknown
These findings suggest that during myelopathy, the intrinsic functional plasticity of the sensory-motor network (SMN) responds to the insufficient sensory and motor experience in CSM patients
This study revealed the following regarding functional plasticity within the SMN: (1) decreased functional connectivity strength (FCS) in the operculum-integrated regions, in which the CSM group showed significantly decreased resting-state functional connectivity (rsFC) regions around the Rolandic sulcus; (2) increased FCS in the premotor, right S1, and parietalintegrated regions, in which the CSM group mainly showed significantly increased rsFC; (3) worsening Japanese Orthopaedic Association (JOA) scores associated with decreased FCS in the operculum-integrated regions and right S1; (4) decreased fractional anisotropy (FA) values at the C2 level that were negatively correlated with rsFC between the premotor regions and integrated regions but positively correlated with the rsFC inter-region of the somatosensory network
Summary
Several neuroimaging studies have suggested brain reorganisation in patients with cervical spondylotic myelopathy (CSM); the changes in spontaneous neuronal activity that are associated with connectedness remain largely unknown. Correlation analysis showed that altered FCS (in the left premotor-ventral/ precentral-operculum, right operculum-parietale 4, and right S1) was associated with worsening Japanese Orthopaedic Association scores and that the rsFC pattern was influenced by cervical cord micro-structural damage at the C2 level Together, these findings suggest that during myelopathy, the intrinsic functional plasticity of the SMN responds to the insufficient sensory and motor experience in CSM patients. Together, these results could reveal abnormalities of connectedness across the SMNs of CSM patients in terms of functional plasticity and reorganisation
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