脊髓损伤后的大脑变化：一项定量荟萃分析和综述。
Brain changes after spinal cord injury, a quantitative meta-analysis and review.
机构信息
Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA.
Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA; Departments of Psychiatry and Radiology, Massachusetts General Hospital, Harvard Medical School, MA, USA; Center for Pain and the Brain, Boston Children's Hospital and Massachusetts General Hospital (MGH), Harvard Medical School, Boston, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
出版信息
Neurosci Biobehav Rev. 2018 Jul;90:272-293. doi: 10.1016/j.neubiorev.2018.04.018. Epub 2018 Apr 24.
Spinal Cord Injuries (SCI) lead to alterations in brain structure and brain function by direct effects of nerve damage, by secondary mechanisms, and also by longer term injury consequences such as paralysis and neuropathic pain. Here, we review neuroimaging studies of patients with traumatic spinal cord injuries, perform a quantitative meta-analysis of motor and motor imagery studies, summarize structural studies, evidence of cortical reorganization, and provide an overview of diffusion and spectroscopy studies. The meta-analysis showed significantly altered motor cortex, as well as cerebellar and parietal lobe changes, and qualitatively consistent reports of alterations in somatosensory brain structure, cortical reorganization, white matter diffusion and thalamic metabolites. Larger samples in combination with standardized imaging protocols and data sharing will further our understanding of brain changes after SCI and help in defining short and long-term changes in brain systems in SCI patients. Such data would provide a basis for clinical trials, treatment outcomes, and guide novel interventions.
脊髓损伤 (SCI) 通过神经损伤的直接影响、继发性机制以及长期的损伤后果（如瘫痪和神经病理性疼痛）导致大脑结构和功能的改变。在这里，我们回顾了创伤性脊髓损伤患者的神经影像学研究，对运动和运动想象研究进行了定量荟萃分析，总结了结构研究、皮质重组的证据，并提供了扩散和光谱研究的概述。荟萃分析显示运动皮层以及小脑和顶叶发生了明显的变化，并且有定性一致的报告表明感觉脑结构、皮质重组、白质扩散和丘脑代谢物发生了改变。更大的样本量结合标准化的成像方案和数据共享将有助于我们深入了解 SCI 后的大脑变化，并帮助确定 SCI 患者大脑系统的短期和长期变化。这些数据将为临床试验、治疗结果提供依据，并指导新的干预措施。
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