Zhao Rui, Song Yingchao, Guo Xing, Yang Xiaotian, Sun Haoran, Chen Xukang, Liang Meng, Xue Yuan
Department of Orthopedics Surgery, Tianjin Medical University General Hospital, Tianjin, China.
School of Medical Imaging, Tianjin Medical University, Tianjin, China.
Front Hum Neurosci. 2021 Jun 23;15:632829. doi: 10.3389/fnhum.2021.632829. eCollection 2021.
Degenerative cervical myelopathy (DCM) damages the spinal cord, resulting in long-term neurological impairment including motor and visual deficits. Given that visual feedback is crucial in guiding movements, the visual disorder may be a cause of motor deficits in patients with DCM. It has been shown that increased functional connectivity between secondary visual cortices and cerebellum, which are functionally related to the visually guided movements, was correlated with motor function in patients with DCM. One possible explanation is that the information integration between these regions was increased to compensate for impaired visual acuity in patients with DCM and resulted in better visual feedback during motor function. However, direct evidence supporting this hypothesis is lacking. To test this hypothesis and explore in more detail the information flow within the "visual-cerebellum" system, we measured the effective connectivity (EC) among the "visual-cerebellum" system dynamic causal modeling and then tested the relationship between the EC and visual ability in patients with DCM. Furthermore, the multivariate pattern analysis was performed to detect the relationship between the pattern of EC and motor function in patients with DCM. We found (1) significant increases of the bidirectional connections between bilateral secondary visual cortices and cerebellum were observed in patients with DCM; (2) the increased self-connection of the cerebellum was positively correlated with the impaired visual acuity in patients; (3) the amplitude of effectivity from the cerebellum to secondary visual cortices was positively correlated with better visual recovery following spinal cord decompression surgery; and (4) the pattern of EC among the visual-cerebellum system could be used to predict the pre-operative motor function. In conclusion, this study provided direct evidence that the increased information integration within the "visual-cerebellum" system compensated for visual impairments, which might have importance for sustaining better motor function in patients with DCM.
退行性颈椎脊髓病(DCM)会损害脊髓,导致包括运动和视觉缺陷在内的长期神经功能障碍。鉴于视觉反馈在指导运动中至关重要,视觉障碍可能是DCM患者运动缺陷的一个原因。研究表明,与视觉引导运动功能相关的次级视觉皮层和小脑之间功能连接性增加,这与DCM患者的运动功能相关。一种可能的解释是,这些区域之间的信息整合增加,以补偿DCM患者受损的视力,并在运动功能期间产生更好的视觉反馈。然而,缺乏支持这一假设的直接证据。为了验证这一假设并更详细地探索“视觉-小脑”系统内的信息流,我们通过动态因果模型测量了“视觉-小脑”系统之间的有效连接性(EC),然后测试了DCM患者中EC与视觉能力之间的关系。此外,进行了多变量模式分析,以检测DCM患者中EC模式与运动功能之间的关系。我们发现:(1)在DCM患者中观察到双侧次级视觉皮层和小脑之间的双向连接显著增加;(2)小脑增加的自连接与患者受损的视力呈正相关;(3)从小脑到次级视觉皮层的有效性幅度与脊髓减压手术后更好的视觉恢复呈正相关;(4)视觉-小脑系统内的EC模式可用于预测术前运动功能。总之,本研究提供了直接证据,表明“视觉-小脑”系统内增加的信息整合补偿了视觉损伤,这可能对维持DCM患者更好的运动功能具有重要意义。
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