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The study on magnetic resonance imaging after complete thoracic spinal cord injuryObjective:To explore the changes of brain gray matter volume(GMV)and cortical morphology after complete thoracic spinal cord injury(SCI),as well as the changes of structural covariance networks(SCNs),and analyse the correlation between GMV changes and clinical variables.Using regional homogeneity(ReHo)and amplitude low frequency fluctuations(ALFF)to explore the differences of brain functional networks in resting state,we expect to obtain better understanding of the brain reorganization and changes after complete thoracic spinal cord injury,and develop guidance for more accurate and specific rehabilitation training strategies for complete spinal cord injury patients.Methods:24 patients with complete thoracic spinal cord injury and 26 healthy controls were recruited in this study.We used voxel-based morphology(VBM)and Surface-based Morphometry(SBM)to analyze brain morphological changes,and SCNs graph theory network analysis based on GMV and SBM methods to analysis the changes of SCNs in patients with complete thoracic spinal cord injury within 1 year.And used partial correlation analysis to explore the relationship between GMV changes and clinical variables.To explore the differences in spontaneous activity of neurons in resting state,by comparing ReHo and ALFF between patients with complete thoracic spinal cord injury and healthy controls.Results:Compared with healthy controls,SCI patients' GMV of the left middle frontal cortex,right superior orbital frontal cortex and left inferior orbital frontal cortex decreased(Family-wise Error(FEW)correction,voxel level p<0.05).SBM analysis showed gyrification index in SCI group was lower in the lateral orbital frontal lobe and the insula,the sqrtsulc in the superior frontal gyrus was decreased,and the cortical thickness in the rostral middle frontal,superior temporal gyrus,inferior frontal gyrus pars opercularis,and inferior frontal gyrus pars triangularis is significantly reduced(P<0.001,FWE correction).The SCNs of the gray matter volume structure demonstrated that the Betweenness Centrality(BC)of the right anterior cingulate cortex(ACC)and the left orbitofrontal cortex(OFC)of SCI patients were significantly increased,and the node degree and node efficiency of the bilateral OFCs were significantly increased.The BC of the right putamen of SCI patients was significantly lower than healthy controls.The SCNs analysis of the cortex thickness showed the BC of the inferior frontal gyrus pars triangularis and left entorhinal cortex of SCI patients was significantly increased,while the BC of the left precentral gyrus was lower than the control group.The node degree and node efficiency of the bilateral cuneus of SCI patients were significantly lower,while the node degree of right superior parietal cortex was significantly lower than healthy controls.Partial correlation analysis showed that the GMV of the right middle frontal cortex of SCI patients was negatively correlated with the SDS score(r=-0.503,p=0.017).Compared with the healthy controls,the ReHo values of the right postcentral gyrus,right cerebellum,and right fusiform gyrus of SCI patients were significantly higher(p=0.001,cluster=10).The ALFF value of bilateral cerebellum increased(p=0.05,cluster=80).Conclusion:The reduction of GMV after complete thoracic spinal cord injury mainly involves the brain region related to cognition,instead of the sensorimotor region.The efficiency of information transmission in the cognition region is improved,and neuropsychological treatment should be considered in the early stage of rehabilitation to prevent irreversible structural changes in the psychological cognition region.After complete spinal cord injury,the efficiency of information transmission in the primary motor cortex and vision-related brain regions is reduced,while the efficiency of information transmission in the brain regions related to motor control increases.It mainly involves movement observation and imitation,which can be involved in rehabilitation training programs.The spontaneous neuronal activity of the brain has changed after complete spinal cord injury,mainly involving sensorimotor brain regions.Part ? Study on the resting state EEG study after complete spinal cord injuryObjective:To explore the resting state electroencephalography(EEG)of patients with complete thoracic spinal cord injury,including the activity characteristics of power spectra and the coherence,and explore the changes in neuroelectrophysiology after complete thoracic spinal cord injury.Method:27 patients with complete thoracic spinal cord injury and 26 healthy controls were enrolled in this study.The frequency domain characteristics of spontaneous EEG in patients with complete thoracic spinal cord injury were analyzed by power spectrum analysis and coherence analysis.Results:Delta,Theta,and Alphal wave of SCI patients were significantly higher than healthy controls.The Theta to Beta ratio(TBR)index(p=0.484)of the complete thoracic spinal cord injury group was significantly higher.EEG coherence analysis showed the coherence coefficient of each electrode pair in Theta,Alphal and Alpha2 frequency bands of patients with complete spinal cord injury in the closed eye state is lower than healthy controls,while there is no significant difference in eyes open state.Conclusion:Power spectra were changed in Delta,Theta and Alpha wave in SCI patients,it may be related with depression and cognition problem.Attention disorders among SCI patients may be overlooked.The change of coherence value after complete thoracic spinal cord injury may be the explanation for the impairments of working memory,attention,task executive function after complete spinal cord injury.Part ? Longitudinal fMRI and EEG Study after rehabilitation of complete thoracic spinal cord injuryObjective:To explore the changes in brain structure and function of patients with complete thoracic spinal cord injury by functional magnetic resonance imaging(fMRI)and EEG after 3 months of rehabilitation training.Methods:A total of 8 patients with complete thoracic spinal cord injury were recruited in this study.VBM and SBM analysis,and SCNs graph network analysis were used to detect brain anatomic and functional network changes in complete thoracic spinal cord injury patients after 3 months of rehabilitation training.The changes of spontaneous neuron activity in resting state of patients with complete thoracic spinal cord injury after 3 months of rehabilitation training were analyzed by comparing ReHo and ALFF.Results:After rehabilitation training,the whole brain GMV of patients significantly increased,and the cortical thickness of postcentral gyrus,precentral gyrus,cingulate gyrus and parahippocampal gyrus increased.Topological network analysis showed that there was no significant difference in global properties before and after rehabilitation training.GMV-based structural covariant network analysis found that the nodal degree of inferior temporal gyrus and the BC of amygdala and fusiform gyrus increased after training,while SBM-based structural covariant network analysis found that the nodal degree of orbitofrontal lobe and superior temporal gyrus increased.The ReHo and ALFF in resting state fMRI were decreased after training.EEG analysis showed that changes in power spectrum of Delta,Theta,Alpha and Beta wave with complete thoracic spinal cord injury after rehabilitation training,mainly in the frontal lobe,parietal and occipital regions.Conclusion:After 3 months of rehabilitation training following complete thoracic spinal cord injury,the anatomy and function of the brain have changed.These changes occur not only in sensorimotor regions,but also in non-motor sensorimotor regions such as the regions involving of mood,emotion,behavior,cognition,and vision.In future rehabilitation training,we will focus on the recovery of sensorimotor function,at the same time need to consider mood,emotion,behavior and cognitive functions as well. |
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