A Study Of Depression And Rest-state Brain Function-mRI In Cervical Spondylotic Myelopathy Patients

Pur Pose:1. To investigate the effect of depression symptoms on the surgery outcome among the posterior decompression of the cervical spondylotic myelopathy(CSM) patients.2.To study the differences of brain resting-state function between CSM patients and health subject.Materials and methods:1. Between October 2006 and October 2011 in our hospital, laminectomy or laminoplasty was performed in 396 cases and to participate in the study. There were132 males and 264 females with an average age of 60.2 years(ranged,39~84 years).All patients were divided into depression group and non-depressed group by the21-item Beck Depression Inventory(BDI). There were no statistically significant differences between the groups in age, sex, smoking status, duration of symptoms,employment status(whether in the current working), And than compared the Japanese Orthopedic Association(JOA) scores, Neck disability index(NDI) and visual analogue scale(VAS) after 1.5months postsurgery. All statistical analyses were performed using SPSS/PC(version 20.0, SPSS, Chicago, IL, USA). Statistical methods included the x2-test with class variables(sex, smoking status, employment status) and the Student t-test with continuous variables(age, duration of symptoms,JOA, NDI, VAS).2.There are a total of 20 people in the study(10 in test group and 10 in control group).All the test group patients are come from Orthopaedics of Tianjin Medical University General Hospital. Inclusion criteria of test group patients included:(1) volunteer to enroll in the study;(2) clear imaging(CT or MRI) evidence of cervical spinal cord compression and spine deterioration;(3) presence typical clinnial symptoms and objective sign of sensorimotor function of CSM. Exclusion criteria included:(1)refusal by the patient to enroll;(2) trauma or infection related to cervical spinal cord compression; and(3) other neurological disorders such as multiple sclerosis, or a history of trauma. Control group included: age-, sex-, right-handed and educational history matched with test grope and with no previous clinical history of CSM orneurological disease were recruited.MR data acquisition: MRI scans were performed using a 3.0 Tesla MRI scanner(Trio Tim, Siemens, Erlangen, Germany). Sagittal and axial conventional T1 W, T2 W and T2-FLAIR images were acquired in the brain and cervical spinal cord for diagnosis in each subject. Subjects were instructed to their keep eyes closed and not to think about anything in particular, and not to fall asleep.Date processing of resting state function-MRI: with REST pakage and SPM8(statistical parametric mapping) in Matlab 7.0 platform to deal with the date。Results:1.The patients with continuous depression showed poorer improvement than the non-depressed patients in the surgery outcome: JOA improved 1.42(±0.56) versus6.76(±3.12),(t=2.01, p=0.008); NDI declined 7.31(±2.18) versus 21.11(±11.36),(t=2.82, p=0.036); and VAS lightened 16.08(±19.76) versus 23.85(±20.79),(t=5.14,p=0.005).2.Compared with healthy subjects, increased amplitude of Amplitude of low-frequence fluetuation(ALFF)was observed in the frontal lobe, parietal lobe,corpus callosum, limbic lobe, cingulate gyrus area.Conclusion:1. Depression contributed a dissatisfied surgery outcome on functional recovery,disability index and pain scores among the posterior decompression of the cervical spondylotic myelopathy patients.2.There are differences of ALFF between CSM patients and health subjects.