Application of task-state fMRI in evaluating disease severity
and prognosis of cervical spondylotic myelopathy

doi:10.3969/j.issn.2095-4344.2703

Abstract

Abstract:

BACKGROUND: Blood oxygenation level dependent functional MRI (BOLD-fMRI) has proven to be a powerful tool for studying the functional change of the brain. In task-state fMRI study, the functional reorganization of sensory and motor cortex has been observed in patients with cervical spondylotic myelopathy.

OBJECTIVE: To discuss the correlations between task-state fMRI measurements with clinical symptoms and surgical outcomes of cervical spondylotic myelopathy.

METHODS: Eighty-two patients with cervical spondylotic myelopathy undergoing posterior cervical decompression (cervical spondylotic myelopathy group) and forty-five healthy volunteers (normal group) were recruited from January 2018 to January 2019. All subjects underwent fMRI and performed a finger-tapping paradigm with the right hand. The Japanese Orthopaedic Association score was used to evaluate the function of the spinal cord. Japanese Orthopaedic Association score recovery rate less than 50% was defined as a poor result.

RESULTS AND CONCLUSION: (1) Japanese Orthopaedic Association score was significantly improved after surgery in the cervical spondylotic myelopathy group compared with that before surgery (P < 0.05). (2) The volume of activation (VOA) in the left precentral gyrus was significantly higher in the cervical spondylotic myelopathy group than in the normal group preoperatively (P < 0.05). There were no significant differences in the VOA in the left postcentral gyrus between cervical spondylotic myelopathy and normal groups (P > 0.05). Before surgery, VOA ratio (left precentral gyrus/left postcentral gyrus) was significantly higher in the cervical spondylotic myelopathy group than in normal group (P < 0.05). (3) In 6-month follow-up, the VOA in the left precentral gyrus was significantly reduced compared with that preoperatively in the cervical spondylotic myelopathy group (P < 0.05). There were no significant differences in the VOA in the left postcentral gyrus compared with that preoperatively (P > 0.05). VOA ratio was significantly decreased compared with that preoperatively (P < 0.05). (4) Correlation analysis revealed that the VOA in the left precentral gyrus and left postcentral gyrus and VOA ratio were significantly correlated with preoperative Japanese Orthopaedic Association score and postoperative Japanese Orthopaedic Association score recovery rate (P < 0.05). The absolute value of correlation coefficient of VOA ratio with preoperative Japanese Orthopaedic Association score and postoperative recovery rate was largest. (5) Receiver operating characteristic curve analysis showed that the area under the curve value for the VOA ratio was 0.803, indicating strong predictive discrimination, and the cut-off value was 3.621. The area under the curve value for Japanese Orthopaedic Association score was 0.751, and the cut-off value was 8. The predictive effect of VOA ratio was higher than Japanese Orthopaedic Association score. (6) The results indicate that the VOA in the left precentral gyrus and left postcentral gyrus was negatively correlated with severity of clinical symptoms (Japanese Orthopaedic Association score). Preoperative VOA ratio can effectively predict the recovery of spinal cord function after operation in patients with cervical spondylotic myelopathy.

Key words: cervical spondylotic myelopathy, decompression, surgical, functional magnetic resonance imaging, cortical reorganization, Japanese Orthopaedic Association score

CLC Number:

Song Yancheng, Kang Liqing, Shen Canghai, Liu Fenghai, Feng Yongjian. Application of task-state fMRI in evaluating disease severity and prognosis of cervical spondylotic myelopathy [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(21): 3341-3346.

Figures/Tables 7

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