Alterations in resting-state brain connectivity in patients with cervical spondylotic myelopathy: an fNIRS study

This study aimed to investigate the alterations in resting-state functional connectivity (rsFC) in patients with cervical spondylotic myelopathy (CSM) using functional near-infrared spectroscopy (fNIRS), and to explore the neuropathological mechanisms underlying these changes.

Fifteen CSM patients (JOA score: 12.3 ± 2.1) and 15 age-matched healthy controls (HCs) underwent fNIRS recording during an eyes-open resting state. Hemodynamic signals were acquired from 63 channels covering the prefrontal, parietal, and occipital cortices. Pearson correlation coefficients were calculated for channel-wise time series, and group differences in FC matrices were compared using two-sample t-tests (p < 0.05) with false discovery rate (FDR) correction.

CSM patients exhibited significantly enhanced connectivity between the secondary somatosensory cortex and premotor/somatosensory association cortices at the total hemoglobin (HbT) level compared to HCs (frontal eye field-supramarginal gyrus: 0.77220 ± 0.09584 vs. 0.600266 ± 0.141879, FDR p < 0.05). Hyperconnectivity was observed between the right occipital lobe and bilateral prefrontal cortices in CSM patients (left prefrontal-right occipital: 0.18390 ± 0.117860 vs. 0.049514 ± 0.11688, FDR p < 0.05; right prefrontal-right occipital: 0.190342 ± 0.144897 vs. 0.0544925 ± 0.0856284, FDR p < 0.05). Notably, the right occipital lobe showed more pronounced hyperconnectivity with the right dorsolateral prefrontal cortex ( 0.26741 ± 0.11123 vs. 0.02533 ± 0.13632, FDR p < 0.01).

This study provides the first fNIRS-based evidence of characteristic functional network changes and compensatory reorganization in CSM patients. The observed hyperconnectivity between the occipital and prefrontal cortices may reflect neuroplastic responses to visual and chronic sensorimotor deficits, while global integration impairments could underlie clinical disabilities. These quantifiable connectivity signatures offer novel targets for monitoring disease progression and evaluating therapeutic interventions.