Study On White Matter Microstructure In Patients With Cervical Spondylotic Myelopathy Based On TBSS

Objective:Exploring white matter microstructure damage on cervical spondylotic myelopathy(CSM)patients with tract-based spatial statistics(TBSS),to understand the brain structural mechanisms of clinical dysfunction in CSM patients by analyzing the correlation between diffusion tensor imaging(DTI)parameters and clinical manifestations.Methods:According to the inclusion and exclusion criteria,a total of 31 cases of CSM patients confirmed by clinical manifestation and imaging examination were recruited for this study.At the same time,29 healthy volunteers who matched the age and gender of the CSM group were recruited as the health control group(HC).The CSM group and the HC group underwent the conventional magnetic resonance imaging(MRI)scans of the brain and cervical spine,excluding the patients with brain lesions and cervical spinal cord lesions(except CSM).Two groups underwent further whole brain DTI data acquisition.We adopt FSL software to preprocess DTI data of all participants,and then obtained DTI parameters maps,including fractional anisotropy(FA),mean diffusivity(MD),axial diffusivity(AD),radial diffusivity(RD).The DTI parameters of CSM group and HC group were tested by two sample t test based on TBSS,to extract the DTI parameters of the significantly different brain regions between the two groups.Finally,correlation between DTI parameters and Japanese orthopaedic association scores(JOA)were analyzed by Pearson’s correlation analysis.Result:(1)Compared with the HC,the FA value of bilateral corticospinal tract,bilateral corona radiata,left cerebral peduncle,left anterior thalamic radiation,left superior longitudinal fasciculus,genu and body corpus callosum in patients with CSM decreased significantly(p< 0.05,FWE corrected).(2)Compared with the HC,the MD value of CSM group was significantly increased in right superior corona radiata,rightanterior thalamic radiation,column and body of fornix,body of corpus callosum,right inferior fronto-occipital fasciculus,right posterior limb of internal capsule,right external capsule,right medial lemniscus,right superior longitudinal fasciculus,right stria terminalis(p < 0.05,FWE corrected).(3)Compared with the HC,the AD value of CSM group was decreased in left anterior corona radiate,left external capsule,right posterior corona radiata,body and splenium corpus callosum(p < 0.05,FWE corrected).(4)Compared with the HC,the RD value of CSM group was increased in right corticospinal tract,right posterior corona radiata,right inferior fronto-occipital fasciculus,right inferior longitudinal fasciculus,splenium corpus callosum(p < 0.05,FWE corrected).(5)In CSM patients,the FA value of the left corticospinal tract and left cerebral peduncle was positively correlated with JOA scores,while the MD value of right posterior limb of internal capsule was negatively correlated with JOA scores(p < 0.05,uncorrected).Pearson correlation analysis showed that revealed no correlations between the AD value,the RD value and JOA scores(p > 0.05,uncorrected).Conclusions:(1)In this study,it was found that the white matter microstructures in the brain regions of CSM patients were altered,which indicated that the white matter structures of CSM patients were damaged or reorganized.(2)The DTI parameter values of abnormal brain areas in CSM patients are correlated with sensory and motor disorders,suggesting that there is a corresponding brain structural basis for clinical dysfunction in CSM patients.