The Correlation Betw Een Functional Connectivity Of The Primary Somatosensory Cortex And Cervical Spinal Cord Diffusion Tensor Imaging In Patients With Cervical Spondylotic Myelopathy

Objective: By studying the functional connections of sensory networks of the brain,the changes of diffusion tensor imaging(DTI)of cervical spinal cord injury in patients with cervical Spondylotic myelopathy(CSM)and the correlation between them,To investigate the neural mechanism of sensory junction network recombination and the value of DTI in the evaluation of cervical spinal cord chronic injury in patients with CSM.Methods: Collected 33 cases of patients with CSM diagnosed by clinical and routine MRI imaging in our hospital and 23 cases of healthy volunteers with age and sex matched as healthy controls(HC)group.Two groups were performed with resting state functional magnetic resonance imaging and cervical spinal cord diffusion tensor imaging;rs-fMRI data was preprocessed by DPARSFA software,Six subregions of bilateral primary somatosensory cortex(S1)were selected as the regions of interest(ROIs),then they were proceed the whole functional connectivity based on the seed point correlation analysis and analysed by using two sample t-test bewteen two groups;Apparent diffusion coefficien(ADC)and fractional aniostropy(FA)values of the cervical spinal cord from C2/3 to C6/7 in the HC group and in the CSM group(multiple segments under pressure take the most severe segment)were measured respectively.ADC and FA values of different segments in HC group were compared.ADC and FA values of fhe cervical spinal cord in the two group were compared respectively;Then,the FC value of different brain area were made correlations with ADC and FA values of the cervical spinal cord(p<0.05).Results:(1)Compared with the HC group,the S1 ROIs-left hand area of CSM group in the resting state showed significantly decreased functional connectivity in the left angular gyrus,left inferior temporal gyrus and right middle temporal gyrus;the S1 ROIs-left leg area of CSM group showed significantly decreased functional connectivity in the left angular gyrus;the S1 ROIs-right chest area of CSM group showed significantly decreased functional connectivity in the bilateral angular gyrus,bilateral superior frontal gyrus,left medial frontal gyrus,left middle frontal gyrus,left middle temporal gyrus/inferior temporal gyrus and left cerebellum posterior lobe;the S1 ROIs-right leg area of CSM group also showed significantly decreased functional connectivity in the left angular gyrus(false discovery rate correction,FDR,p<0.05,clusters?10).(2)In the CSM group,the mean FC between the S1 ROIs-left hand area and the left angular gyrus showed a significantly negative correlation with the NDI score;the mean FC between the S1 ROIs-left hand area and the left inferior temporal gyrus showed a significantly positive correlation with the JOA score of upper Sensory deficit;and the mean FC between the S1 ROIs-right leg area and the left angular gyrus also showed a significantly positive correlation with the JOA score of lower Sensory deficitscore(p<0.05).(3)ADC value showed an ascending trend from C2/3 to C6/7,while FA value showed a descending trend.The ADC value of the cervical medulla in C2/3 segment was significantly lower than that of C3/4,C4/5,C5/6 and C6/7,while the FA value was significantly higher.Compared with C5/6 and C6/7 segments,the ADC value of the cervical spinal cord was significantly lower than that of C5/6 and C6/7,while the FA value was significantly higher than that of C4/5,C5/6 and C6/7.Both C4/5 and C5/6 segments of the cervical medullary ADC were significantly lower than those in the C6/7 segment,while the FA values were significantly higher(p<0.05).(4)ADC value of the cervical spinal cord in the CSM group showed significant increase while FA value showed significant decrease compared with that of the control group respectively(p<0.05).(5)There was a positive correlation between FA value of cervical spinal cord and JOA score,motor,especially motor upper,while there was a positive correlation between FA value of bilateral posterior cervical spinal cord and JOA score,sensor deficit,especially lower sensor deficit(p<0.05).(6)In the CSM group,the mean FC between the S1 ROIs-left leg area and the left angular gyrus,and the mean FC between the S1 ROIs-right chest area and the left middle temporal gyrus/inferior temporal gyrus showed a significantly positive correlation with the ADC value of bilateral posterior cervical spinal cord;the mean FC between the S1 ROIs-right chest area and the left cerebellum posterior lobe showed a significantly positive correlation with the FA value of bilateral posterior cervical spinal cord.Conclusions:(1)The abnormalities in FC of sensorimotor in CSM patients,indicative of cortical reorganization.(2)The DTI imaging parameters(ADC and FA)of CSM patients can assess the functional damage degree after spinal cord injury.(3)Chronic cervical spinal cord microstructural injury and cortical sensory network compensatory recombination have significant synchronism in CSM patients,and The DTI imaging parameters of bilateral posterior cervical spinal cord can moderately and objectively reflect the degree of sensory impairment in the cerebral cortex of the patients.