Functional MRI evidence for primary motor cortex plasticity contributes to the disease's severity and prognosis of cervical spondylotic myelopathy patients

Eur Radiol. 2022 Jun;32(6):3693-3704. doi: 10.1007/s00330-021-08488-3. Epub 2022 Jan 14.

Abstract

Objective: To investigate the brain mechanism of non-correspondence between diseases severity and compression degree of the spinal cord in cervical spondylotic myelopathy (CSM) patients and to test the utility of brain imaging biomarkers for predicting prognosis of CSM.

Methods: We calculated voxel-wise zALFF from 54 CSM patients and 50 healthy controls using resting-state fMRI data. In analysis 1, we identified the brain regions exhibited significant differences of zALFF between CSM patients and healthy controls. In analyses 2 through 3, we investigated the zALFF differences between light-symptom CSM patients and severe-symptom CSM patients while carefully matching the degree of compression between these two groups. In analysis 4, we tested the utility of zALFF within the primary motor cortex (M1) for predicting the prognosis of CSM.

Results: We found that (1) compared with the healthy controls, CSM patients exhibited higher ALFF within left M1, bilateral superior frontal gyrus, and lower zALFF within right precuneus and calcarine, suggesting altered brain neural activity in CSM patients; (2) after matching the compression degree, the CSM patients with more severe clinical symptoms exhibited higher zALFF within M1, indicating cortical function contributes to disease's severity of CSM; (3) taking the M1 zALFF as features in the prognosis prediction model improves the prediction accuracy, indicating that the M1 zALFF provide additional value for predicting the prognosis of CSM patients following decompression surgery.

Conclusion: The functional state of M1 contributes to the disease's severity of CSM and can provide complementary information for predicting the prognosis of CSM following decompression surgery.

Key points: • Cervical spondylotic myelopathy (CSM) patients exhibited increased zALFF within the primary motor cortex (M1), bilateral superior frontal gyrus, and decreased zALFF within the right precuneus and calcarine. • After matching the compression degree, the CSM patients with more severe clinical symptoms exhibited higher zALFF within M1, indicating cortical function contributes to disease severity of CSM. • zALFF within M1 provided additional value for predicting the prognosis of CSM patients.

Keywords: Functional Magnetic resonance imaging; Machine learning; Primary motor cortex; Spinal cord diseases.

MeSH terms

  • Cervical Vertebrae / diagnostic imaging
  • Cervical Vertebrae / surgery
  • Decompression, Surgical / methods
  • Humans
  • Magnetic Resonance Imaging / methods
  • Motor Cortex* / diagnostic imaging
  • Motor Cortex* / surgery
  • Prognosis
  • Spinal Cord Compression* / diagnostic imaging
  • Spinal Cord Diseases* / diagnostic imaging
  • Spinal Cord Diseases* / surgery
  • Spondylosis* / diagnostic imaging