The Correlation between Functional Connectivity of the Primary Somatosensory Cortex and Cervical Spinal Cord Microstructural Injury in Patients with Cervical Spondylotic Myelopathy.

Guoshu Zhao,Chenlei Zhang,Yaru Zhan,Laichang He

doi:10.1155/2022/2623179

Abstract

Objectives To explore functional connectivity reorganization of the primary somatosensory cortex, the chronic microstructure damage of the cervical spinal cord, and their relationship in cervical spondylotic myelopathy (CSM) patients. Methods Thirty-three patients with CSM and 23 healthy controls (HCs) were recruited for rs-fMRI and cervical spinal cord diffusion tensor imaging (DTI) scans. Six subregions (including leg, back, chest, hand, finger and face) of bilateral primary somatosensory cortex (S1) were selected for seed-based whole-brain functional connectivity (FC). Then, we calculated the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of the cervical spinal cord. Correlation analysis was conducted between FC values of brain regions and DTI parameters of cervical spinal cord (ADC, FA), and their relationship with each other and clinical parameters. Results Compared with the HC group, the CSM group showed decreased FC between areas of the left S1hand, the left S1leg, the right S1chest, and the right S1leg with brain regions. The mean FA values of the cervical spinal cord in CSM patients were positively correlated with JOA scores. Especially, the FApos values of bilateral posterior funiculus were positively correlated with JOA scores. The ADC and FA values of bilateral posterior funiculus in the cervical spinal cord were also positively correlated with the FC values. Conclusions There was synchronization between chronic cervical spinal cord microstructural injury and cerebral cortex sensory function compensatory recombination. DTI parameters of the posterior cervical spinal cord could objectively reflect the degree of cerebral cortex sensory function impairment to a certain extent.

Highlights

Cervical spondylotic myelopathy (CSM) is the most common disorder that causes sensory and motor function impairment in the upper and lower limbs [1]
There was no significant difference in sex and age between CSM patients and healthy control (HC)
The main brain regions were as follows: (1) bilateral postcentral; (2) bilateral frontal lobe, which were consisted of precentral gyrus (PreCG), superior frontal gyrus (SFG), middle frontal gyrus (MFG), and inferior frontal gyrus (IFG); (3) bilateral temporal lobe, which were consisted of superior temporal gyrus (STG), middle temporal gyrus (MTG), and inferior temporal gyrus (ITG); (4) bilateral parietal lobe, which were consisted of superior parietal lobule (SPG) and inferior parietal lobule (IPG); (5) bilateral occipital lobe, which were consisted of inferior occipital gyrus (IFG); (6) limbic system, which were consisted of hippocampus (HIP) and parahippocampal gyrus (PHG), anterior cingulate gyrus (ACG) and posterior cingulate gyrus (PCG), and bilateral insular (INS); (7) bilateral cerebellar posterior lobe; and (8) right rolandic operculum (ROL)

Summary

Introduction

Cervical spondylotic myelopathy (CSM) is the most common disorder that causes sensory and motor function impairment in the upper and lower limbs [1]. The longterm compression of the cervical spinal cord can cause the degeneration of the anterior horn and motor neurons, even the lateral and posterior funiculus axons demyelination [2]. Compared with conventional MRI, diffusion tensor imaging (DTI) has higher sensitivity and specificity for the detection of CSM. The apparent diffusion coefficient (ADC) and fractional aniostropy (FA) can detect white matter lesions before the high signal of T2 weighted image (T2WI), and FA can be a biomarker for the severity of myelopathy and for subsequent surgical outcome [3]. Most of the current studies have not taken into account the anatomical factors of the spinal cord, such as the distribution of gray matter and white matter in the spinal cord and the distribution of sensory and motor fibers in the anterior, posterior, and lateral funiculus [4,5,6]. As a special spinal cord injury, CSM still needs more detailed studies on the cervical spinal cord, especially on DTI of dorsal column tracts (fasciculus gracilis and fasciculus cuneatus)

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Results

Conclusion