脊髓损伤会扰乱人脑的静息态网络。

Spinal Cord Injury Disrupts Resting-State Networks in the Human Brain.

机构信息

1 Department of Neurological Surgery, Washington University School of Medicine , Saint Louis, Missouri.

2 Department of Biomedical Engineering, Washington University School of Medicine , Saint Louis, Missouri.

出版信息

J Neurotrauma. 2018 Mar 15;35(6):864-873. doi: 10.1089/neu.2017.5212. Epub 2018 Jan 11.

Abstract

Despite 253,000 spinal cord injury (SCI) patients in the United States, little is known about how SCI affects brain networks. Spinal MRI provides only structural information with no insight into functional connectivity. Resting-state functional MRI (RS-fMRI) quantifies network connectivity through the identification of resting-state networks (RSNs) and allows detection of functionally relevant changes during disease. Given the robust network of spinal cord afferents to the brain, we hypothesized that SCI produces meaningful changes in brain RSNs. RS-fMRIs and functional assessments were performed on 10 SCI subjects. Blood oxygen-dependent RS-fMRI sequences were acquired. Seed-based correlation mapping was performed using five RSNs: default-mode (DMN), dorsal-attention (DAN), salience (SAL), control (CON), and somatomotor (SMN). RSNs were compared with normal control subjects using false-discovery rate-corrected two way t tests. SCI reduced brain network connectivity within the SAL, SMN, and DMN and disrupted anti-correlated connectivity between CON and SMN. When divided into separate cohorts, complete but not incomplete SCI disrupted connectivity within SAL, DAN, SMN and DMN and between CON and SMN. Finally, connectivity changed over time after SCI: the primary motor cortex decreased connectivity with the primary somatosensory cortex, the visual cortex decreased connectivity with the primary motor cortex, and the visual cortex decreased connectivity with the sensory parietal cortex. These unique findings demonstrate the functional network plasticity that occurs in the brain as a result of injury to the spinal cord. Connectivity changes after SCI may serve as biomarkers to predict functional recovery following an SCI and guide future therapy.

摘要

尽管美国有 25.3 万名脊髓损伤 (SCI) 患者,但人们对 SCI 如何影响大脑网络知之甚少。脊髓 MRI 仅提供结构信息,无法了解功能连接。静息态功能磁共振成像 (RS-fMRI) 通过识别静息态网络 (RSN) 来量化网络连接,并允许在疾病期间检测到功能相关的变化。鉴于脊髓传入大脑的网络非常强大,我们假设 SCI 会导致大脑 RSN 发生有意义的变化。对 10 名 SCI 患者进行了 RS-fMRI 和功能评估。采集了血氧依赖的 RS-fMRI 序列。使用五个 RSN(默认模式网络 (DMN)、背侧注意网络 (DAN)、突显网络 (SAL)、控制网络 (CON) 和躯体运动网络 (SMN))进行基于种子的相关映射。使用错误发现率校正的两向 t 检验将 RSN 与正常对照组进行比较。SCI 降低了 SAL、SMN 和 DMN 内的大脑网络连接,并破坏了 CON 和 SMN 之间的反相关连接。当分为单独的队列时,完全性但非不完全性 SCI 破坏了 SAL、DAN、SMN 和 DMN 内以及 CON 和 SMN 之间的连接。最后,SCI 后连接随时间发生变化:初级运动皮层与初级体感皮层的连接减少,视觉皮层与初级运动皮层的连接减少,视觉皮层与体感顶叶皮层的连接减少。这些独特的发现表明,由于脊髓损伤,大脑中会发生功能网络可塑性。SCI 后的连接变化可能作为预测 SCI 后功能恢复的生物标志物,并指导未来的治疗。

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