[Influence of Cervical Spondylotic Spinal Cord Compression on Cerebral Cortical Adaptation. Radiological Study]

Area of Science:

• Neuroscience
• Radiology
• Orthopedics

Background:

• Cervical spondylotic myelopathy (CSM) involves spinal cord compression, potentially leading to sensorimotor deficits.
• Functional magnetic resonance imaging (fMRI) can visualize brain activity related to motor tasks.
• Assessing brain adaptation in response to CSM is crucial for understanding disease progression and treatment outcomes.

Purpose of the Study:

• To measure sensorimotor brain adaptation activity using fMRI.
• To correlate brain activity with the degree of spinal cord compression in CSM patients detected by MRI.
• To evaluate changes in brain activity before and after surgical decompression.

Main Methods:

• Included 21 patients with anterior cervical cord compression.
• Assessed spinal cord compression, signal intensity changes, neurological status (JOA, NDI, VAS), and electrophysiological tests (MEP, SEP).
• Measured brain activity using fMRI during arm movements, comparing pre- and post-operative scans.

Main Results:

• Advanced myelopathy correlated with pathological MEP/SEP findings and significantly higher pre-operative fMRI brain activation volume.
• No significant difference in fMRI between subgroups based on transverse spinal cord area.
• Surgery moderately reduced active brain tissue volume, with significant changes in motor cortex and cerebellar activation in advanced myelopathy patients.

Conclusions:

• Brain exhibits increased activity as a delayed response to spinal cord damage.
• Significant spinal cord signal changes in advanced myelopathy correlate with functional deterioration and compensatory cortical motor activation.
• fMRI reveals altered cortical motor activation patterns post-decompression surgery, suggesting adaptive brain changes.