Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China.
J Magn Reson Imaging. 2021 Nov;54(5):1551-1559. doi: 10.1002/jmri.27764. Epub 2021 Jun 1.
Studies have shown that loss of sensorimotor function in spinal cord injury (SCI) leads to brain functional reorganization, which may play important roles in motor function recovery. However, the specific functional changes following SCI are still poorly understood.
To investigate whether there are functional reorganizations outside the sensorimotor regions after complete thoracolumbar SCI (CTSCI), and how these reorganizations are associated with clinical manifestations.
Prospective.
Eighteen CTSCI patients (28-67 years of age; 16 men) and 18 age-, gender-matched healthy controls (HCs) (27-64 years of age; 16 men).
FIELD STRENGTH/SEQUENCE: Resting-state functional magnetic resonance imaging (RS-fMRI) using echo-planar-imaging (EPI) sequence at 3.0 T.
Data preprocessing was performed using Data Processing Assistant for Resting-State fMRI (DPARSF). Amplitude of low-frequency fluctuations (ALFF) was used to characterize regional neural function, and seed-based functional connectivity (FC) was used to evaluate the functional integration of the brain network.
Two-sample t-tests were used for ALFF and FC measures (the data conform to the normal distribution), partial correlation analysis was used to analyze the correlation between clinical and imaging indicators, and receiver operating characteristic (ROC) analysis was used to search for sensitive imaging indicators.
Compared with HCs, CTSCI patients showed decreased ALFF in right lingual gyrus (LG), increased ALFF in right middle frontal gyrus (MFG), and decreased FC between the right LG and Vermis_3 (cluster-level FWE correction with P < 0.05). Subsequent correlation analyses revealed that decreased FC between the right LG and Vermis_3 positively correlated with the visual analog scale (VAS) (P = 0.043, r = 0.443). Finally, the ROC analysis showed that the area under the curve (AUC) of FC value between right LG and Vermis3 was 0.881.
These findings suggest a possible theoretical basis of the mechanism of visual-, emotion-, and cognition-related techniques in rehabilitation training for CTSCI.
研究表明，脊髓损伤（SCI）导致感觉运动功能丧失会引起大脑功能重组，这可能对运动功能恢复起着重要作用。然而，SCI 后具体的功能变化仍知之甚少。
探讨完全胸腰段脊髓损伤（CTSCI）后感觉运动区以外是否存在功能重组，以及这些重组与临床表现的关系。
前瞻性研究。
18 例 CTSCI 患者（年龄 28-67 岁；16 名男性）和 18 名年龄、性别匹配的健康对照组（HCs）（年龄 27-64 岁；16 名男性）。
磁场强度/序列：在 3.0T 磁共振扫描仪上使用回波平面成像（EPI）序列进行静息态功能磁共振成像（RS-fMRI）。
使用静息态 fMRI 数据处理助手（DPARSF）进行数据预处理。采用局部一致性（ALFF）分析来描述局部脑区的神经活动，采用种子点功能连接（FC）分析来评估脑网络的功能整合。
对 ALFF 和 FC 指标进行两样本 t 检验（数据符合正态分布），采用偏相关分析对临床和影像学指标进行相关性分析，采用受试者工作特征（ROC）分析寻找敏感的影像学指标。
与 HCs 相比，CTSCI 患者右侧舌回（LG）的 ALFF 降低，右侧额中回（MFG）的 ALFF 升高，右侧 LG 与小脑蚓部 3 区（Vermis_3）之间的 FC 降低（cluster-level FWE 校正，P < 0.05）。进一步的相关性分析显示，右侧 LG 与小脑蚓部 3 区之间 FC 的降低与视觉模拟评分（VAS）呈正相关（P=0.043，r=0.443）。最后，ROC 分析显示右侧 LG 与小脑蚓部 3 区 FC 值的曲线下面积（AUC）为 0.881。
这些发现为 CTSCI 康复训练中视觉、情感和认知相关技术的作用机制提供了可能的理论依据。
