Sensorimotor Network Alterations and Compensation in Cervical Spondylotic Myelopathy: A 7 T Task-Based and...

Area of Science:

• Neuroimaging
• Spinal Cord Medicine
• Neurology

Background:

• Cervical spondylotic myelopathy (CSM) is a primary cause of spinal cord dysfunction.
• The neural mechanisms behind motor impairment and recovery in CSM are not fully understood.

Purpose of the Study:

• To investigate sensorimotor network alterations in CSM patients using 7 Tesla functional MRI (fMRI).
• To explore the relationship between brain network changes and clinical severity.

Main Methods:

• Utilized task-based and resting-state 7T fMRI in 16 CSM patients and controls.
• Assessed motor function using Japanese Orthopaedic Association (JOA) scores.
• Conducted 3-month postoperative follow-up imaging for 10 patients.

Main Results:

• CSM patients showed compensatory bilateral brain activation, particularly in the ipsilateral motor cortex and contralateral cerebellum.
• Increased connectivity was observed in sensorimotor networks, including M1, sensory cortex, and M1-SMA connections.
• Cerebellar hyperactivation and altered network connectivity negatively correlated with clinical severity (JOA scores).

Conclusions:

• CSM induces compensatory brain reorganization involving the cerebellum and motor cortex with severity-dependent hyperconnectivity.
• Findings clarify motor compensation mechanisms in CSM.
• Suggests cerebellar-focused rehabilitation as a potential therapeutic approach for CSM.