脊髓型颈椎病减压术后功能重塑的多模态磁共振研究

项目名称： 脊髓型颈椎病减压术后功能重塑的多模态磁共振研究

项目编号： No.81460329

项目类型： 地区科学基金项目

立项/批准年度： 2015

项目学科： 医药、卫生

项目作者： 何来昌

作者单位： 南昌大学

项目金额： 47万元

中文摘要： 脊髓型颈椎病(CSM)是由椎体及相邻软组织退变造成脊髓慢性压迫性病变，是中老年人非外伤性肢体功能损害的常见原因。外科减压是CSM患者缓解症状的主要疗法。以往研究集中于受压脊髓及其解压后的功能重塑，然感觉运动皮质(SMC)功能重塑对临床功能恢复的影响及其与脊髓功能重塑间的关系尚不十分清楚。本组初步发现CSM患者术前存在fMRI可检测到的SMC功能异常、皮质-丘脑连接异常，可能对术后功能重塑起到重要作用。基于此，本研究拟采用多模态磁共振技术(vMRI、DTI、MRS、Task-fMRI和rs-fMRI)从形态、结构、代谢、任务和静息态功能多角度探讨CSM患者减压术后脊髓和皮质功能重塑的可能病理生理机制，皮质重塑对脊髓功能重塑的影响，结合临床功能评估遴选CSM可能的术前预后影像学标志。本研究有望揭示CSM患者术前术后皮质中枢-脊髓交互作用的可能机制，为理解其他类型脊髓损伤提供理论基础和技术支持。

中文关键词： 功能磁共振成像；弥散张量成像；脊髓型颈椎病；功能重塑

英文摘要： Cervical spondylotic myelopathy (CSM) caused by vertebrae or the adjacent soft tissue degeneration of chronic spinal cord compression is the most common type of spinal cord dysfunction in middle-aged and elderly people.Surgery decompression is the primary treatment for relieve symptoms in CSM patients. The majority of studies on spinal cord compression focus on functional recovery and reorganization of the compression of the spinal cord and after decompression remodeling,however the sensorimotor cortex (SMC) function reorganization effect on clinical functional recovery and the relationship between spinal cord function restore is not very clear. In previous work by our group, we demonstrated abnormal function of SMC and the alteration of thalamo-cortical synchronization of sensorimotor circuits in patients with CSM, may influence functional reorganization.Base on this, we explore the alteration of cortical morphology, structure, metabolites, task and resting-state fMRI by multi-modality MRI (vMRI,DTI,MRS, task-fMRI and rs-fMRI) as it applies to imaging sensorimotor and whole brain damage of CSM patients; Comparison of preoperative and postoperative of functional MRI and DTI topography in the spinal cord and brain data, and clinciclly functional evaluation data in order to investigate the reorganization mechanism of brain. To make comparison across patients and controls and their disease severity(clinical evaluated score), duration of symptoms and the mean fractional anisotropy (FA) values in the cervical cord (means spinal cord damage severity) were collected to assess its clinical relevance and medical imaging marker in pre-surgery. This study provides a new insight into understanding of the plasticity pathophysiology of cortex - spinal cord in preoperative or post-surgery in cervical myelopathy patients, and to provid the theory foundation and technical support of the cortical functional reorganization of other patients with spinal cord injury.

英文关键词： functional MRI;diffusion tensor imaging;cervical spondylotic myelopathy;functional reorganization