Pan Yu, Dou Wei-Bei, Wang Yue-Heng, Luo Hui-Wen, Ge Yun-Xiang, Yan Shu-Yu, Xu Quan, Tu Yuan-Yuan, Xiao Yan-Qing, Wu Qiong, Zheng Zhuo-Zhao, Zhao Hong-Liang
Department of Rehabilitation, Beijing Tsinghua Changgung Hospital; School of Clinical Medicine, Tsinghua University, Beijing, China.
Department of Electronic Engineering, Tsinghua University, Beijing, China.
Neural Regen Res. 2017 Dec;12(12):2059-2066. doi: 10.4103/1673-5374.221165.
Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury (SCI). The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI (mean age 40.94 ± 14.10 years old; male:female, 7:11) and 18 healthy subjects (37.33 ± 11.79 years old; male:female, 7:11) were studied by resting state functional magnetic resonance imaging. Gray matter volume (GMV) and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex (BA1) and left primary motor cortex (BA4), and left BA1 and left somatosensory association cortex (BA5) was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR-ROC-17013566).
脑可塑性，包括解剖学变化和功能重组，是脊髓损伤（SCI）后功能恢复的生理基础。SCI后脑解剖学变化与功能重组之间的相关性尚不清楚。本研究旨在探讨不完全性SCI后感觉运动区皮质结构和网络功能的改变是否同时存在。采用静息态功能磁共振成像对18例不完全性SCI患者（平均年龄40.94±14.10岁；男∶女=7∶11）和18名健康受试者（37.33±11.79岁；男∶女=7∶11）进行研究。分别采用灰质体积（GMV）和功能连接性来评估皮质结构和网络功能。与健康受试者相比，不完全性SCI患者感觉运动区的GMV无显著改变。SCI患者左侧初级躯体感觉皮层（BA1区）与左侧初级运动皮层（BA4区）、左侧BA1区与左侧躯体感觉联合皮层（BA5区）之间的半球内功能连接性降低，左侧BA1区与右侧BA4区、左侧BA1区与右侧BA5区、左侧BA4区与右侧BA5区之间的半球间功能连接性也降低。两个BA4区之间的功能连接性也降低。SCI患者左侧BA1区与右侧BA4区之间降低的功能连接性与美国脊髓损伤协会感觉评分呈正相关。结果表明，不完全性SCI患者感觉运动区皮质解剖结构和网络功能连接性的改变并非同时存在，提示感觉运动区的网络功能变化可能不依赖于解剖结构。感觉运动区内功能连接的强度可作为评估和预测不完全性SCI患者感觉功能的潜在影像生物标志物。本试验已在中国临床试验注册中心注册（注册号：ChiCTR-ROC-17013566）。
