Cronin Alicia E, Detombe Sarah A, Duggal Camille A, Duggal Neil, Bartha Robert
Department of Medical Biophysics, The University of Western Ontario, London, Ontario N6A 3K7, Canada.
Centre for Functional and Metabolic Mapping, Robarts Research Institute, The University of Western Ontario, London, Ontario N6A 3K7, Canada.
Brain Commun. 2021 Jun 22;3(3):fcab131. doi: 10.1093/braincomms/fcab131. eCollection 2021.
The impact of spinal cord compression severity on brain plasticity and prognostic determinates is not yet fully understood. We investigated the association between the severity of spinal cord compression in patients with degenerative cervical myelopathy, a progressive disease of the spine, and functional plasticity in the motor cortex and subcortical areas using functional magnetic resonance imaging. A 3.0 T MRI scanner was used to acquire functional images of the brain in 23 degenerative cervical myelopathy patients. Patients were instructed to perform a structured finger-tapping task to activate the motor cortex to assess the extent of cortical activation. T-weighted images of the brain and spine were also acquired to quantify the severity of spinal cord compression. The observed blood oxygen level-dependent signal increase in the contralateral primary motor cortex was associated with spinal cord compression severity when patients tapped with their left hand ( = 0.49, = 0.02) and right hand ( = 0.56, = 0.005). The volume of activation in the contralateral primary motor cortex also increased with spinal cord compression severity when patients tapped with their left hand ( = 0.55, = 0.006) and right hand ( = 0.45, = 0.03). The subcortical areas (cerebellum, putamen, caudate and thalamus) also demonstrated a significant relationship with compression severity. It was concluded that degenerative cervical myelopathy patients with severe spinal cord compression recruit larger regions of the motor cortex to perform finger-tapping tasks, which suggests that this adaptation is a compensatory response to neurological injury and tissue damage in the spinal cord.
脊髓压迫严重程度对脑可塑性及预后决定因素的影响尚未完全明确。我们利用功能磁共振成像，研究了退行性颈椎病（一种脊柱的进行性疾病）患者脊髓压迫严重程度与运动皮质及皮质下区域功能可塑性之间的关联。使用一台3.0 T磁共振成像扫描仪获取23例退行性颈椎病患者的脑功能图像。指导患者执行一项结构化的手指敲击任务以激活运动皮质，从而评估皮质激活程度。还获取了脑和脊柱的T加权图像，以量化脊髓压迫的严重程度。当患者用左手敲击时（r = 0.49，P = 0.02）以及用右手敲击时（r = 0.56，P = 0.005），对侧初级运动皮质中观察到的血氧水平依赖信号增加与脊髓压迫严重程度相关。当患者用左手敲击时（r = 0.55，P = 0.006）以及用右手敲击时（r = 0.45，P = 0.03），对侧初级运动皮质的激活体积也随脊髓压迫严重程度增加。皮质下区域（小脑、壳核、尾状核和丘脑）也显示出与压迫严重程度存在显著关系。研究得出结论，脊髓压迫严重的退行性颈椎病患者在执行手指敲击任务时会调动更大范围的运动皮质区域，这表明这种适应性是对脊髓神经损伤和组织损伤的一种代偿反应。
