Contribution of changes in the spinal cord and brain to the onset and progression of hand clumsiness symptoms in cervical spondylotic myelopathy.

IF 2.9 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of neurosurgery. Spine Pub Date : 2024-06-21 Print Date: 2024-09-01 DOI:10.3171/2024.4.SPINE231238
Yan Li, Jianchao Chang, Kun Zhu, Siya Zhang, Junxun Zuo, Bingyong Xie, Haoyu Ni, Jiyuan Yao, Zhibin Xu, Sicheng Bian, Tingfei Yan, Xianyong Wu, Senlin Chen, Weiming Jin, Ying Wang, Peng Xu, Peiwen Song, Yuanyuan Wu, Cailiang Shen, Jiajia Zhu, Yongqiang Yu, Fulong Dong
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引用次数: 0

Abstract

Objective: Cervical spondylotic myelopathy (CSM) stands as the most prevalent form of spinal cord injury, frequently prompting various changes in both the brain and spinal cord. However, the precise nature of these changes within the brains and spinal cords of CSM patients experiencing hand clumsiness (HCL) symptoms has remained elusive. The authors aimed to scrutinize these alterations and explore potential links between these changes and the onset of HCL symptoms.

Methods: Using the modified Japanese Orthopaedic Association (mJOA) scale, the authors classified CSM patients into two groups: those without HCL and those with HCL. The authors performed voxel-wise z-score transformation amplitude of low-frequency fluctuations (zALFF) and resting-state functional connectivity (FC) evaluations in the brain. Additionally, they used the Spinal Cord Toolbox to calculate the fractional anisotropy (FA) of spinal cord tracts. The analysis also encompassed an examination of the correlation of these measures with improvements in mJOA scores.

Results: Significant disparities in zALFF values surfaced in the right calcarine, right cuneus, right precuneus, right middle occipital gyrus (MOG), right superior occipital gyrus (SOG), and right superior parietal gyrus (SPG) between healthy controls (HC), patients without HCL, and patients with HCL, primarily within the visual cortex. In the patient group, patients with HCL displayed reduced FC between the right calcarine, right MOG, right SOG, right SPG, right SFG, bilateral MFG, and left median cingulate and paracingulate gyri when compared with patients without HCL. Moreover, significant differences in FA values of the corticospinal tract (CST) and reticulospinal tract (REST) at the C2 level emerged among HC, patients without HCL, and patients with HCL. Notably, zALFF, FC, and FA values in specific brain regions and spinal cord tracts exhibited correlations with mJOA upper-extremity scores. Additionally, FA values of the CST and REST correlated with zALFF values in the right calcarine, right MOG, right SOG, and right SPG.

Conclusions: Alterations within brain regions associated with the visual cortex, the fronto-parietal-occipital attention network, and spinal cord pathways appear to play a substantial role in the emergence and progression of HCL symptoms. Furthermore, the existence of a potential connection between the spinal cord and the brain suggests that this link might be related to the clinical symptoms of CSM.

脊髓和大脑的变化对颈椎病手部笨拙症状的发生和发展的影响。
目的:颈椎脊髓病(CSM)是脊髓损伤中最常见的一种,经常会引起大脑和脊髓的各种变化。然而,对于出现手部笨拙(HCL)症状的 CSM 患者大脑和脊髓中这些变化的确切性质,人们仍然难以捉摸。作者旨在仔细研究这些变化,并探索这些变化与 HCL 症状发作之间的潜在联系:作者使用改良的日本矫形协会(mJOA)量表将 CSM 患者分为两组:无 HCL 的患者和有 HCL 的患者。作者对大脑中的低频波动振幅(zALFF)和静息态功能连接(FC)进行了体素变换评估。此外,他们还使用脊髓工具箱计算了脊髓束的分数各向异性(FA)。分析还包括研究这些指标与 mJOA 评分改善的相关性:结果:健康对照组(HC)、无 HCL 患者和 HCL 患者之间的 zALFF 值在右侧丘脑、右侧楔状回、右侧楔前回、右侧枕中回(MOG)、右侧枕上回(SOG)和右侧顶上回(SPG)出现了显著差异,主要集中在视觉皮层。在患者组中,与非 HCL 患者相比,HCL 患者右侧卡氏回、右侧 MOG、右侧 SOG、右侧 SPG、右侧 SFG、双侧 MFG 以及左侧扣带回和旁扣带回正中间的 FC 值降低。此外,皮质脊髓束(CST)和网状脊髓束(REST)在C2水平的FA值在HC、无HCL患者和HCL患者之间出现了明显差异。值得注意的是,特定脑区和脊髓束的 zALFF、FC 和 FA 值与 mJOA 上肢评分存在相关性。此外,CST和REST的FA值与右侧心盏、右侧MOG、右侧SOG和右侧SPG的zALFF值相关:结论:与视觉皮层、前顶叶-枕叶注意力网络和脊髓通路相关的脑区的改变似乎在 HCL 症状的出现和发展中起着重要作用。此外,脊髓与大脑之间的潜在联系表明,这种联系可能与 CSM 的临床症状有关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of neurosurgery. Spine
Journal of neurosurgery. Spine 医学-临床神经学
CiteScore
5.10
自引率
10.70%
发文量
396
审稿时长
6 months
期刊介绍: Primarily publish original works in neurosurgery but also include studies in clinical neurophysiology, organic neurology, ophthalmology, radiology, pathology, and molecular biology.
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