Investigation of Resting-State BOLD Networks in the Human Brainstem and Spinal Cord

Resting-state functional magnetic resonance imaging (rs-fMRI) has been used to investigate networks within the cortex and has also provided some insight into the networks present in the brainstem (BS) and spinal cord (SC). The purpose of this study was to investigate resting-state blood oxygenation-level dependent (BOLD) fluctuations in the BS/SC and to identify resting-state networks (RSNs) across these regions. Resting-state BOLD fMRI data were obtained from the entire BS and cervical SC in 16 healthy participants, at 3 T, with T₂-weighted single-shot fast spin-echo imaging. Data were spatially normalized and processed to remove physiological noise. Cluster-cluster functional connectivity was investigated across the entire 3D region by means of temporal correlations, and structural equation modeling (SEM) was used to investigate RSNs. Extensive connectivity was observed within and across BS and SC regions, with connections spanning up to 120 mm, although shorter connections were more prevalent. SEM results revealed extensive brainstem-cord connectivity that included specific anatomical regions within the brainstem. The results indicate the presence of a complex resting-state network which is highly interconnected in the spinal cord. Known anatomical connections between cortical and BS regions support the conclusion that the observed resting-state BOLD fluctuations in the BS/SC may be related to autonomic regulation. Future studies are required to further investigate these resting-state BOLD networks.