Visual cortex neural activity alteration in cervical spondylotic myelopathy patients: a resting-state fMRI study

We sought to investigate visual cortex neural activity and functional connectivity (FC) alterations in cervical spondylotic myelopathy (CSM) patients using resting-state fMRI (rs-fMRI) and to explore the relationships of these alterations with visual disorder.

Twenty-seven CSM patients and 11 healthy controls were recruited as the study and control groups. The amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) values were calculated to represent neural activity, seed-based correlation analysis (SCA) was performed to analyze the FC of visual cortex, and the outcomes were compared between groups. The preoperative best-corrected visual acuity (pre-BCVA) and postoperative BCVA (post-BCVA) of study groups were measured. Correlation analyses of the ALFF/ReHo values with the preoperative and postoperative BCVAs were performed. Correlations of the bilateral BCVAs with the ipsilateral and contralateral visual cortex neural activities were performed.

The ALFF/ReHo values were decreased in the occipital lobe and increased in the cerebellar posterior lobe in the study group (P < 0.05). Increased FC was demonstrated between Brodmann's area 17 and posterior cingulate lobe (P < 0.05). Postoperatively, the BCVAs were ameliorated in 22 oculi dexter (ODs) and 20 oculi sinister (OSs) in the study group. Positive correlations between neural activity in the visual cortex and the preoperative and postoperative BCVAs were detected in the study group. The bilateral BCVAs were positively correlated with either the ipsilateral or contralateral visual cortex neural activity.

Both ALFF/ReHo value changes and positive correlations of these changes with BCVA were demonstrated in CSM. The FC between the visual cortex and posterior cingulate lobe was also increased in CSM.