1Department of Orthopedic Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.
2Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China.
J Neurotrauma. 2019 Aug 1;36(15):2348-2357. doi: 10.1089/neu.2018.6205. Epub 2019 Apr 23.
The objective of the study was to investigate degenerative changes of white matter volume (WMV) and gray matter volume (GMV) in individuals after a spinal cord injury (SCI). Published studies of whole-brain voxel-based morphometry (VBM) published between January 1, 2006 and March 1, 2018 comparing SCI patients with controls were collected by searching PubMed, Web of Science, and EMBASE databases. Voxel-wise meta-analyses of GMV and WMV differences between SCI patients and controls were performed separately using seed-based d mapping. Twelve studies with 12 GMV data sets and 9 WMV data sets yielded a total of 466 individuals (190 SCI patients and 276 controls) who were included in this meta-analysis. Compared with controls, SCI patients showed GMV atrophy in sensorimotor system regions including the bilateral sensorimotor cortex (S1 and M1), the supplementary motor area (SMA), paracentral gyrus, thalamus, and basal ganglia, as well as WMV loss in the corticospinal tract.GMV aberrancies were also demonstrated in brain regions responsible for cognition and emotion, such as the orbitofrontal cortex (OFC) and the left insula. Additionally, GMV in both the bilateral S1 and the left SMA was positively correlated with the time span after the injury. In conclusion, anatomical atrophy in cortical-thalamic-spinal pathways suggested that SCIs may result in degenerative changes of the sensorimotor system. Further, OFC and insula GMV abnormalities may explain symptoms such as neuropathic pain and potential cognitive-emotional impairments in chronic SCI patients. These findings indicate that anatomical brain magnetic resonance imaging (MRI) protocols could be neuroimaging biomarkers for interventional studies and treatments.
本研究旨在探讨脊髓损伤（SCI）后个体的脑白质体积（WMV）和脑灰质体积（GMV）的退行性变化。通过检索 PubMed、Web of Science 和 EMBASE 数据库，收集了 2006 年 1 月 1 日至 2018 年 3 月 1 日期间发表的比较 SCI 患者和对照组的全脑基于体素形态计量学（VBM）的研究。使用基于种子的弥散张量成像（d mapping）分别对 SCI 患者和对照组的 GMV 和 WMV 差异进行体素水平的荟萃分析。纳入了 12 项研究的 12 个 GMV 数据集和 9 个 WMV 数据集，共纳入 466 名个体（190 名 SCI 患者和 276 名对照组）进行荟萃分析。与对照组相比，SCI 患者表现出感觉运动系统区域的 GMV 萎缩，包括双侧感觉运动皮层（S1 和 M1）、辅助运动区（SMA）、中央旁小叶、丘脑和基底节，以及皮质脊髓束的 WMV 损失。GMV 异常也在负责认知和情绪的脑区表现出来，如眶额皮层（OFC）和左侧岛叶。此外，双侧 S1 和左侧 SMA 的 GMV 与损伤后时间跨度呈正相关。总之，皮质-丘脑-脊髓通路的解剖萎缩表明 SCI 可能导致感觉运动系统的退行性变化。此外，OFC 和岛叶 GMV 异常可能解释了慢性 SCI 患者的神经性疼痛和潜在的认知-情绪障碍等症状。这些发现表明解剖学脑磁共振成像（MRI）方案可能成为干预研究和治疗的神经影像学生物标志物。
