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MRI evidence of brain atrophy, white matter damage, and functional adaptive changes in patients with cervical spondylosis and prolonged spinal cord compression.

颈椎病和脊髓长时间压迫患者脑萎缩、白质损伤和功能适应性改变的MRI证据。

  • 影响因子:4.08
  • DOI:10.1007/s00330-019-06352-z
  • 作者列表:"Bernabéu-Sanz Á","Mollá-Torró JV","López-Celada S","Moreno López P","Fernández-Jover E
  • 发表时间:2020-01-01
Abstract

OBJECTIVES:To investigate the effect of cervical spondylosis (CS) in the brain with a combination of advanced neuroimaging techniques. METHODS:Twenty-seven patients with CS and 24 age- and gender-matched healthy controls were studied. Disease severity was quantified using the Modified Japanese Orthopaedic Association Scoring System (mJOHA). Magnetic resonance (MR) imaging of the brain and spinal cord, functional MR imaging (fMRI) with a bilateral rest/finger-tapping paradigm, brain diffusion tensor imaging (DTI), voxel-based morphometry (VBM), and MR spectroscopy of the sensorimotor cortex were performed. RESULTS:A total of 92.3% of patients had more than one herniated disc. In the MRI, 33.33% presented signs of myelopathy. The mJOHA score was 13.03 ± 2.83. Compared with controls, DTI results showed significant lower FA values in Corpus callosum, both corticospinal tracts and middle cerebellar peduncles (p < 0.05 corrected). Only in CS patients fMRI results showed activation in both globus pallidi, caudate nucleus, and left thalamus (p < 0.001). Subject-specific activation of the BOLD signal showed in CS patients lower activation in the sensorimotor cortex and increased activation in both cerebellum hemispheres (p < 0.05 corrected). VBM showed bilateral clusters of gray matter loss in the sensorimotor cortex and pulvinar nucleus (p < 0.05 corrected) of CS patients. NAA/Cr was reduced in the sensorimotor cortex of CS patients (p < 0.05). Linear discriminant and support vector machine analyses were able to classify > 97% of CS patients with parameters obtained from the fMRI, DTI, and MRS results. CONCLUSION:CS may lead to distal brain damage affecting the white and gray matter of the sensorimotor cortex causing brain atrophy and functional adaptive changes. KEY POINTS:• This study suggests that patients with cervical spondylosis may present anatomical and functional adaptive changes in the brain. • Cervical spondylosis may lead to white matter damage, gray matter volume loss, and functional adaptive changes in the sensorimotor cortex. • The results reported in this work may be of value to better understand the effect of prolonged cervical spine compression in the brain.

摘要

目的: 探讨结合先进的神经影像学技术对脑部颈椎病 (CS) 的疗效。 方法: 对 27 例CS患者和 24 例年龄和性别相匹配的健康对照者进行研究。使用改良的日本骨科协会评分系统 (mJOHA) 对疾病严重程度进行量化。脑和脊髓的磁共振 (MR) 成像,双侧静息/手指敲击范式的功能性MR成像 (fMRI),脑弥散张量成像 (DTI),进行基于体素的形态测量学 (VBM) 和感觉运动皮层的MR光谱。 结果: 共有 92.3% 的患者有一个以上的椎间盘突出。在MRI中,33.33% 表现为脊髓病的征象。MJOHA评分为 13.03 ± 2.83。与对照组相比,DTI结果显示胼胝体、皮质脊髓束和小脑中脚的FA值显著降低 (p <0.05 校正)。仅在CS患者中,fMRI结果显示苍白球、尾状核和左丘脑均有激活 (p <0.001)。在CS患者中,BOLD信号的受试者特异性激活显示感觉运动皮层激活较低,两个小脑半球激活增加 (p <0.05 校正)。VBM显示CS患者感觉运动皮质和肺泡核的双侧灰质丢失簇 (p <0.05 校正)。CS患者感觉运动皮质NAA/Cr降低 (p <0.05)。线性判别和支持向量机分析能够用fMRI、DTI和MRS结果获得的参数对> 97% 的CS患者进行分类。 结论: CS可能导致远端脑损伤,影响感觉运动皮层白质和灰质,引起脑萎缩和功能适应性改变。 要点: • 本研究提示颈椎病患者可能呈现大脑解剖和功能适应性改变。•颈椎病可能导致白质损伤、灰质体积丧失和感觉运动皮层的功能适应性改变。•这项工作中报道的结果可能对更好地理解大脑中颈椎长时间压迫的影响有价值。

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作者列表:["Droege M","Sproule D","Arjunji R","Gauthier-Loiselle M","Cloutier M","Dabbous O"]

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METHODS:OBJECTIVES:To investigate the effect of cervical spondylosis (CS) in the brain with a combination of advanced neuroimaging techniques. METHODS:Twenty-seven patients with CS and 24 age- and gender-matched healthy controls were studied. Disease severity was quantified using the Modified Japanese Orthopaedic Association Scoring System (mJOHA). Magnetic resonance (MR) imaging of the brain and spinal cord, functional MR imaging (fMRI) with a bilateral rest/finger-tapping paradigm, brain diffusion tensor imaging (DTI), voxel-based morphometry (VBM), and MR spectroscopy of the sensorimotor cortex were performed. RESULTS:A total of 92.3% of patients had more than one herniated disc. In the MRI, 33.33% presented signs of myelopathy. The mJOHA score was 13.03 ± 2.83. Compared with controls, DTI results showed significant lower FA values in Corpus callosum, both corticospinal tracts and middle cerebellar peduncles (p < 0.05 corrected). Only in CS patients fMRI results showed activation in both globus pallidi, caudate nucleus, and left thalamus (p < 0.001). Subject-specific activation of the BOLD signal showed in CS patients lower activation in the sensorimotor cortex and increased activation in both cerebellum hemispheres (p < 0.05 corrected). VBM showed bilateral clusters of gray matter loss in the sensorimotor cortex and pulvinar nucleus (p < 0.05 corrected) of CS patients. NAA/Cr was reduced in the sensorimotor cortex of CS patients (p < 0.05). Linear discriminant and support vector machine analyses were able to classify > 97% of CS patients with parameters obtained from the fMRI, DTI, and MRS results. CONCLUSION:CS may lead to distal brain damage affecting the white and gray matter of the sensorimotor cortex causing brain atrophy and functional adaptive changes. KEY POINTS:• This study suggests that patients with cervical spondylosis may present anatomical and functional adaptive changes in the brain. • Cervical spondylosis may lead to white matter damage, gray matter volume loss, and functional adaptive changes in the sensorimotor cortex. • The results reported in this work may be of value to better understand the effect of prolonged cervical spine compression in the brain.

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脊髓疾病方向

包括脊髓肿瘤、脊髓非肿瘤样病变和脊髓发育异常。脊髓病变可引起脊髓压迫症。脊髓压迫症是由各种性质的病变引起脊髓、脊神经根及其血管受压的一组病症,可导致患者瘫痪等。

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