PurposeWe employed resting-state fMRI analyses to reveal central functional reorganization in the brains of patients with cervical spondylotic myelopathy (CSM) and to provide complementary evidence of cortex reorganization in these patients.Patients and methodsWe obtained Fisher’s z transformation amplitude of low-frequency fluctuations (zALFF) and Fisher’s z transformation regional homogeneity (zReHo) measurements from 33 patients with CSM and 33 healthy controls (HC) and used the brain regions with significant alterations in the zALFF or zReHo values as seed regions. Then, we calculated Pearson’s correlation coefficients between the resting-state time courses of each seed and the time series of the rest of the brain. Lastly, we computed correlations between the altered zALFF, zReHo, and functional connectivity with Japanese Orthopaedic Association scores, Neck Disability Index score, and the duration of symptoms in patients with CSM.ResultszALFF and zReHo values were increased in the left medial superior frontal gyrus (lSFGmed) and left supramarginal gyrus (lSMG) in patients with CSM compared with those in the HC group. Selecting lSFGmed as the seed, we observed increased functional connectivity between it and the left postcentral gyrus (lPoCG) and left rolandic operculum and decreased functional connectivity with the right medial superior frontal gyrus in patients with CSM. In addition, there was a significant increase in the functional connectivity between the lSMG (seed) and the left calcarine and lPoCG in patients with CSM. However, we did not find any significant correlation between the resting-state findings and the clinical performance of patients with CSM.ConclusionThese observed intrinsic functional changes in the patients with CSM may be related to functional reorganization and reflect the innate cortical plasticity in patients with CSM. Notably, the increased connectivity between the lPoCG and the two seed ROIs indicates the adaptive changes in patients with CSM. These findings provide complementary evidence of cortex reorganization in CSM.
Background: Brain structural alterations play an important role in patients with cervical spondylotic myelopathy (CSM). However, while there have been studies on regional brain structural alterations, only few studies have focused on the topological organization of the brain structural covariance network. This work aimed to describe the structural covariance network architecture alterations that are possibly linked to cortex reorganization in patients with CSM. Methods: High-resolution anatomical images of 31 CSM patients and 31 healthy controls (HCs) were included in the study. The images were acquired using a sagittal three-dimensional T1-weighted BRAVO sequence. Firstly, the gray matter volume of 90 brain regions of automated anatomical labeling atlas were computed using a VBM toolbox based on the DARTEL algorithm. Then, the brain structural covariance network was constructed by thresholding the gray matter volume correlation matrices. Subsequently, the network measures and nodal property were calculated based on graph theory. Finally, the differences in the network metrics and nodal property between groups were compared using a non-parametric test. Results: Patients with CSM showed larger global efficiency and smaller local efficiency, clustering coefficient, characteristic path length, and sigma values than HCs. Patients with CSM had greater betweenness in the left superior parietal gyrus (SPG.L) and the left supplementary motor area (SMA.L) than HCs. Besides, patients with CSM had smaller betweenness in right middle occipital gyrus. The brain structural covariance networks of CSM patients exhibited equal resilience to random failure as those of HCs. However, the maximum relative size of giant connected components was approximately 10% larger in HCs than in CSM patients, upon removal of 44 nodes in targeted attack. Conclusion: These observed alternations in global network measures in CSM patients reflect that the brain structural covariance network in CSM exhibits the less optimal small-world model compared to that in HCs. Increased betweenness in SPG.L and
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