中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (12): 2059-2066.doi: 10.4103/1673-5374.221165

• 原著:脊髓损伤修复保护与再生 • 上一篇    下一篇

不完全性脊髓损伤后感觉运动皮质结构和功能变化非同步发生

  

  • 收稿日期:2017-09-20 出版日期:2017-12-15 发布日期:2017-12-15
  • 基金资助:

    清华大学科学研究项目（2014081266，20131089382）；国家自然科学基金（61171002，60372023）

Non-concomitant cortical structural and functional alterations in sensorimotor areas following incomplete spinal cord injury

Yu Pan1, 2, Wei-bei Dou3, Yue-heng Wang3, Hui-wen Luo3, Yun-xiang Ge3, Shu-yu Yan1, Quan Xu1, Yuan-yuan Tu1, Yan-qing Xiao1,Qiong Wu1, Zhuo-zhao Zheng4, Hong-liang Zhao4   

  1. 1 Department of Rehabilitation, Beijing Tsinghua Changgung Hospital, Beijing, China
    2 School of Clinical Medicine, Tsinghua University, Beijing, China
    3 Department of Electronic Engineering, Tsinghua University, Beijing, China
    4 Department of Radiology, Beijing Tsinghua Changgung Hospital, Beijing, China
  • Received:2017-09-20 Online:2017-12-15 Published:2017-12-15
  • Contact: Yu Pan, M.D. or Wei-bei Dou,Ph.D., py10335@163.com or douwb@tsinghua.edu.cn.
  • Supported by:

    This work was supported by a grant from Tsinghua University Initiative Scientific Research Program, No. 2014081266, 20131089382;and the National Natural Science Foundation of China, No. 61171002, 60372023.

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摘要：

脊髓损伤后大脑结构和功能重组的可塑性变化是功能恢复的生理基础，但脊髓损伤后大脑解剖结构和功能变化的相互关系尚不清楚。试验希望明确不完全性脊髓损伤后感觉运动皮质结构和网络功能变化是否同步发生。我们通过静息态功能性磁共振检测观察不完全性脊髓损伤患者(年龄40.94±14.10岁，男/女：7/11)和健康对照者(年龄37.33±11.79岁，男/女：7/11)各18例的感觉运动皮质灰质体积和功能连接变化情况，分别评估皮质结构和网络功能。与健康对照者比较：(1)脊髓损伤组患者感觉运动皮质灰质体积无明显变化；(2)大脑半球间功能连接下降，区域包括包括左初级躯体感觉皮质(BA1)和右初级运动皮质(BA4)之间、左初级躯体感觉皮质(BA1)和右躯体感觉联合皮质(BA5)之间、左初级运动皮质(BA4)和右躯体感觉联合皮质(BA5)之间、双侧初级运动皮质(BA4)之间；(3)左初级躯体感觉皮质(BA1)和右初级运动皮质(BA4)间功能连接与ASIA感觉评分成正相关；(4)研究结果显示，不完全性脊髓损伤患者感觉运动皮质解剖结构和网络功能连接变化是非同步发生的，不完全性脊髓损伤患者感觉运动皮质网络功能变化可能不依赖解剖结构变化。作者认为，感觉运动皮质间功能连接强度可能成为评估和预测不完全性脊髓损伤患者感觉功能的影像学标志物。

orcid:0000-0002-5703-5322(Yu Pan)

关键词: 神经再生, 不完全性脊髓损伤, 灰质体积, 功能连接, 感觉运动皮质, 功能性磁共振, 脑可塑性, 非同步, 解剖结构, 脑网络, 影像学标志物

Abstract:

Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury (SCI). The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI.Eighteen patients with incomplete SCI (mean age 40.94 ± 14.10 years old; male:female, 7:11) and 18 healthy subjects (37.33 ± 11.79 years old; male:female, 7:11) were studied by resting state functional magnetic resonance imaging. Gray matter volume (GMV) and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex (BA1) and left primary motor cortex (BA4), and left BA1 and left somatosensory association cortex (BA5) was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR-ROC-17013566).

Key words: nerve regeneration, incomplete spinal cord injury, gray matter volume, functional connectivity, sensorimotor areas, functional magnetic resonance imaging, brain plasticity, non-concomitant, anatomical structure, network, imaging biomarker, neural regeneration