退行性颈椎病患者皮质厚度的改变模式:与灵活性和步态功能障碍的关联。

IF 4.1 Q1 CLINICAL NEUROLOGY Brain communications Pub Date : 2024-09-04 eCollection Date: 2024-01-01 DOI:10.1093/braincomms/fcae279
Fauziyya Muhammad, Kenneth A Weber, Michael Rohan, Zachary A Smith
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引用次数: 0

摘要

颈椎退行性脊髓病(DCM)可导致大脑结构发生重大重组。皮质变化与 DCM 患者特定运动症状之间的关联尚未完全阐明。我们在一项病例对照研究中调查了 DCM 患者皮质厚度变化与神经症状(如灵活性和步态异常)之间的关联。我们使用 3 特斯拉核磁共振成像扫描仪采集了 30 名右利手 DCM 患者和 22 名年龄匹配的健康对照者的高分辨率 T1 加权结构扫描图像。与健康对照组相比,DCM 患者的皮质明显变薄,尤其是在双侧中央前回和前额叶、左侧三角旁、左侧中央后回、右侧颞横纹和视觉皮质(P ≤ 0.04)。值得注意的是,这些区域的皮质厚度与客观运动障碍有很强的相关性(P < 0.0001)。具体来说,前额叶皮层、前运动区和辅助运动区的皮层厚度明显减少,与灵活性下降相关(R2 = 0.33,P < 0.0007;R2 = 0.34,P = 0.005)。同样,步态功能的下降也与视觉运动皮层和额叶眼场皮层厚度的减少有关(R2 = 0.39,P = 0.029;R2 = 0.33,P = 0.04)。有趣的是,只有对侧楔前叶厚度与日本矫形协会(mJOA)的总体评分相关(R2 = 0.29,P = 0.003)。然而,mJOA 的上肢子分数表明与视觉皮层和前额叶相关(R2 = 0.48,P = 0.002;R2 = 0.33,P = 0.0034)。总之,我们的研究结果揭示了与运动障碍相关的皮层变化模式,突出了结合客观临床和脑成像评估来了解 DCM 运动网络功能障碍的重要性。
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Patterns of cortical thickness alterations in degenerative cervical myelopathy: associations with dexterity and gait dysfunctions.

Degenerative cervical myelopathy (DCM) can lead to significant brain structural reorganization. The association between the cortical changes and specific motor symptoms in DCM has yet to be fully elucidated. We investigated the associations between cortical thickness changes with neurological symptoms, such as dexterity and gait abnormalities, in patients with DCM in a case-control study. A 3 Tesla MRI scanner was used to acquire high-resolution T1-weighted structural scans from 30 right-handed patients with DCM and 22 age-matched healthy controls. Pronounced cortical thinning was observed in DCM patients relative to healthy controls, particularly in the bilateral precentral and prefrontal gyri, left pars triangularis, left postcentral gyrus, right transverse temporal and visual cortices (P ≤ 0.04). Notably, cortical thickness in these regions showed strong correlations with objective motor deficits (P < 0.0001). Specifically, the prefrontal cortex, premotor area and supplementary motor area exhibited significant thickness reductions correlating with diminished dexterity (R2 = 0.33, P < 0.0007; R2 = 0.34, P = 0.005, respectively). Similarly, declines in gait function were associated with reduced cortical thickness in the visual motor and frontal eye field cortices (R2 = 0.39, P = 0.029, R2 = 0.33, P = 0.04, respectively). Interestingly, only the contralateral precuneus thickness was associated with the overall modified Japanese Orthopaedic Association (mJOA) scores (R2 = 0.29, P = 0.003). However, the upper extremity subscore of mJOA indicated an association with the visual cortex and the anterior prefrontal (R2 = 0.48, P = 0.002, R2 = 0.33, P = 0.0034, respectively). In conclusion, our findings reveal patterns of cortical changes correlating with motor deficits, highlighting the significance of combining objective clinical and brain imaging assessments for understanding motor network dysfunction in DCM.

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