| 章晨蕾,谭永明,何来昌,钟军,郭建强,周福庆.静息态fMRI观察脊髓型颈椎病患者初级躯体感觉皮层功能连接[J].中国医学影像技术,2019,35(1):36~40 |
| 静息态fMRI观察脊髓型颈椎病患者初级躯体感觉皮层功能连接 |
| Resting-state fMRI observation on functional connectivity of primary somatosensory cortex in patients with cervical spondylotic myelopathy |
| 投稿时间：2018-04-24 修订日期：2018-09-21 |
| DOI：10.13929/j.1003-3289.201804134 |
| 中文关键词: 脊髓型颈椎病 躯体感觉皮质 磁共振成像 |
| 英文关键词:cervical spondylotic myelopathy somatosensory cortex magnetic resonance imaging |
| 基金项目:国家自然科学基金（81460329）、中国博士后科学基金（2013M541877）、江西省卫生计生委科技计划项目（20155111）。 |
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| 中文摘要: |
| 目的 采用静息态fMRI观察脊髓型颈椎病（CSM）患者大脑初级躯体感觉皮层（S1）功能连接的改变。方法 对33例CSM患者（CSM组）及23名健康志愿者（对照组）行静息态fMRI，将双侧S1各分为6个感觉亚区（手指、上肢、下肢、胸部、背部和头面部）作为ROI，提取ROI信号，并与大脑其他脑区行基于体素水平相关性分析，获得功能连接系数并构建功能连接图；以双样本t检验比较CSM组与对照组间大脑功能连接的差异，并分析差异脑区功能连接值与临床功能量表评分间的相关性。结果 与对照组比较，静息状态下CSM组S1左侧上肢感觉亚区与左侧角回、左侧颞下回、右侧颞中回功能连接减低；S1左侧下肢感觉亚区与左侧角回功能连接减低；S1右侧胸部感觉亚区与双侧角回、双侧额上回、左侧内侧额上回、左侧额中回、左侧颞中回/颞下回、右侧小脑后叶功能连接减低；S1右侧下肢感觉亚区与左侧角回功能连接减低（P<0.05，FDR校正）。CSM患者S1左侧上肢感觉亚区与左侧角回的功能连接值与颈椎功能障碍指数评分（NDI）呈负相关（r=-0.377，P=0.031）；S1左侧上肢感觉亚区与左侧颞下回的功能连接值与上肢感觉日本骨科协会（JOA）评分呈正相关（r=0.353，P=0.044）；S1右侧下肢感觉亚区与左侧角回的功能连接值与下肢感觉JOA评分呈正相关（r=0.406，P=0.019）。结论 CSM患者存在与感觉运动相关功能连接异常，提示CSM患者已发生大脑皮层功能重组。 |
| 英文摘要: |
| Objective To explore changes of functional connectivity of primary somatosensory cortex (S1) in patients with cervical spondylotic myelopathy (CSM) using resting-state fMRI. Methods Resting-state fMRI was performed in 33 patients with CSM (CSM group) and 23 healthy volunteers (control group). Bilateral S1 were divided into 6 sensory sub-regions (finger, hand, leg, chest, back, face) as the ROI. ROI signals were extracted and analyzed based on the correlation of voxel levels with other brain regions, the functional connection coefficient was obtained, and the functional connection map was constructed. The brain functional connectivity between CSM group and control group were compared with two-sample t test. The correlation between the functional connectivity values of the differential brain regions and the clinical functional scale scores were analyzed. Results Compared with control group, the functional sub-region of the left hand of S1 in CSM group reduced with the left angular gyrus, the left inferior temporal gyrus and the right middle temporal gyrus in the resting state, while the function connection of S1 left leg sensory sub-region and left angular gyrus also reduced. S1 right chest sensory sub-region of CSM group showed significantly decreased functional connectivity with the bilateral angular gyrus, bilateral superior frontal gyrus, left medial superior frontal gyrus, left middle frontal gyrus, left middle temporal gyrus/inferior temporal gyrus and right cerebellum posterior lobe. The functional connection between S1 right leg sensory sub-region and the left angular gyrus reduced (P<0.05, FDR correction). The functional connectivity between S1 left hand sensory sub-region and the left angular gyrus negatively correlated with neck disability index scores (NDI; r=-0.377, P=0.031), while the functional connectivity value of S1 left hand sensory sub-region and left inferior temporal gyrus positively correlated with the upper extremity sensation of the Japanese Orthopaedic Association (JOA) score (r=0.353, P=0.044).The functional connectivity value of S1 right leg sensory sub-region and the left angular gyrus also showed significantly positive correlation with the lower extremity sensation JOA scores (r=0.406, P=0.019). Conclusion The abnormalities in functional connectivity of sensorimotor exist in CSM patients, indicating cortical reorganization in CSM patients. |
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