Department of Orthopedics, Shandong First Medical University/ West China Hospital, Sichuan University, Chengdu, Shandong/Sichuan, China.
Department Spinal Surgery, Jinan Central Hospital Affiliated to Shandong University, Jinan, Shandong, China.
Neuroradiology. 2019 Nov;61(11):1309-1318. doi: 10.1007/s00234-019-02272-3. Epub 2019 Aug 16.
Reorganization of the brain is considered the key mechanism of functional recovery in patients after spinal cord injury (SCI). This meta-analysis assessed abnormal brain activation in SCI patients to understand the pattern of reorganization in the brain after SCI.
Functional magnetic resonance imaging (fMRI) studies that compared SCI patients with controls and were published before August 30, 2018, were extracted from the PubMed, Web of Science, and EMBASE databases. Voxel-wise whole-brain meta-analysis and region-of-interest meta-analysis of group differences were separately performed. Then, meta-regression analysis was conducted with several clinical characteristics as regressors.
Sixteen studies that met the inclusion criteria were identified. Compared with control individuals, SCI patients showed increased activation in the sensorimotor cortex in both whole-brain and region-of-interest (ROI) analyses. In addition, whole-brain meta-analysis revealed increased activation in the cerebellum, and this increase was positively correlated with lesion level and injury severity.
Our results demonstrated that reorganization occurred mainly in the sensorimotor system of the brain after SCI, implying that brain functions involved in sensorimotor demands can still be preserved in this condition. These findings provide opportunities for future studies in terms of therapeutic strategies and prognosis assessment.
脑的重组被认为是脊髓损伤（SCI）患者功能恢复的关键机制。本荟萃分析评估了 SCI 患者的异常脑激活情况，以了解 SCI 后大脑的重组模式。
从 PubMed、Web of Science 和 EMBASE 数据库中提取了截至 2018 年 8 月 30 日比较 SCI 患者和对照组的功能磁共振成像（fMRI）研究。分别进行了全脑体素水平荟萃分析和组间差异的感兴趣区荟萃分析。然后，使用几个临床特征作为回归变量进行了元回归分析。
确定了符合纳入标准的 16 项研究。与对照组相比，SCI 患者在全脑和感兴趣区（ROI）分析中均表现出感觉运动皮层的激活增加。此外，全脑荟萃分析还显示小脑的激活增加，且这种增加与损伤水平和损伤严重程度呈正相关。
我们的结果表明，SCI 后大脑的重组主要发生在感觉运动系统中，这意味着在这种情况下，与感觉运动需求相关的大脑功能仍然可以保留。这些发现为治疗策略和预后评估的未来研究提供了机会。
