Magnetic Resonance Imaging Based On Low Frequency Fluctuation And Arterial Spin Labeling For Chronic Neck And Shoulder Pain Caused By Cervical Spondylotic Radiculopathy

Objectives:To identify the changes of intrinsic brain activity and regional cerebral blood flow in cervical spondylotic radiculopathy with chronic neck and shoulder pain(CSR-CNSP)using two magnetic resonance imaging(MRI)techniques,the amplitude of low frequency fluctuation(ALFF)analysis of resting-state functional MRI(rs-fMRI)and the arterial spin labeling(ASL)perfusion MRI.And to correlate the altered values of ALFF and CBF in CSR-CNSP patients to some clinical data in order to explore the central mechanism of CSR-CNSP.Methods:In total,28 CSR-CNSP patients and 25 healthy controls(HCs)underwent rs-fMRI and ASL MRI.The brain images after scanning were preprocessed with DPABI_V4.0 and SPM12 two toolboxes based on MATLAB 2018b.Subsequently,the differences in ALFF and CBF were compared in the two groups.Finally,Pearson's correlation analysis was performed between the mean values of ALFF and CBF with the visual analog scale(VAS)and disease duration in CSR-CNSP group.Results:Compared with HCs,the ALFF values had decreased in the left precuneus,right cingulate gyrus,left middle temporal gyrus,right middle frontal gyrus,left precentral gyrus,right postcentral gyrus,right middle occipital gyrus,and increased in the right precuneus,left middle orbitofrontal gyrus,left medial superior frontal gyrus,bilateral cerebellum posterior lobe(P<0.05,AlphaSim corrected,Cluster Size>24).The decrease of CBF was mainly observed in the right middle frontal gyrus,left precentral gyrus,and the increase of CBF in the right middle temporal gyrus,bilateral superior parietal gyrus(P<0.05,AlphaSim corrected,Cluster Size>289).The ALFF mean value of left medial superior frontal gyrus in CSR-CNSP group was positively correlated with the VAS score(r=0.106,P=0.023).Conclusions:CSR-CNSP caused abnormal changes of ALFF and CBF in several brain regions of the default mode network,frontal lobe,parietal lobe,occipital lobe and cerebellum,which were involved in pain perception,pain modulation,movement,emotion,cognition and so on.The ALFF mean value of the left medial superior frontal gyrus was positively correlated with the VAS score,which indicated that the spontaneous nerve activity in this brain region could objectively reflect the pain intensity of CSR-CNSP patients.The combination of rs-fMRI and ASL perfusion MRI provide complementary information for increasing our understanding of the neuropathology in CSR-CNSP.