Resting-State Magnetoencephalography Functional Connectivity in Cervical Spondylotic Myelopathy: An MEG Study with...

The diagnosis of cervical spondylotic myelopathy (CSM) relies mainly on clinical symptoms and structural imaging, highlighting the need for objective functional biomarkers. This study investigated alterations in resting-state magnetoencephalography (MEG) functional connectivity in CSM and evaluated whether multiband weighted phase lag index (wPLI) features could distinguish CSM patients from healthy controls (HCs). Eyes-closed resting-state MEG data were acquired from 31 CSM patients and 32 HCs. Region-of-interest-level wPLI connectivity was calculated in the theta, alpha, beta, and gamma bands and used to train multiple machine learning classifiers. Model performance was assessed using nested group cross-validation, and SHapley Additive exPlanations (SHAP) were used to interpret the best-performing model. Patients with CSM exhibited frequency-specific connectivity alterations, particularly in the theta and gamma bands. Logistic regression achieved the best overall discriminative performance, and SHAP analysis indicated that classification was driven mainly by long-range theta-band connections and gamma-band connections involving the frontal pole. These findings suggest that CSM is associated with measurable reorganization of large-scale cortical networks and that resting-state MEG connectivity combined with explainable machine learning may provide a promising framework for exploring candidate neurophysiological biomarkers of CSM.