基于fMRI的脊髓型颈椎病脑重塑的研究进展  

Research progress on brain plasticity of cervical spondylotic myelopathy based on fMRI

作　　者：葛志超 孙浩[1] 吴佳佳 赵庆[1] GE Zhi-chao;SUN Hao;WU Jia-jia;ZHAO Qing(Dept.of Orthopedics,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院骨二科,上海200437

出　　处：《同济大学学报（医学版）》2021年第3期426-431,共6页Journal of Tongji University(Medical Science)

基　　金：国家自然科学基金(81902301)。

摘　　要：脊髓型颈椎病是常见的慢性颈椎病,即使手术解除脊髓压迫,仍有部分患者肢体功能恢复欠佳。其原因可能是脊髓受压的同时,大脑由于长时间感觉输入和运动输出刺激异常,而发生功能重塑。本文对近年来利用功能磁共振成像研究脊髓型颈椎病脑功能重塑的研究进行综述。脊髓型颈椎病患者从大脑局部活动、脑区间功能连接、到各个尺度脑网络拓扑属性,以及大脑白质的弥散张量属性均发生了功能性重塑,且与症状及预后相关。脊髓型脊椎病的治疗除了对受压迫的相应脊髓节段的精准减压外,还应当关注所引发的脑重塑。对其进行脑功能层面的神经调控治疗,可能对提升短期疗效以及远期康复疗效具有重要意义。Cervical spondylotic myelopathy(CSM)is a common chronic cervical spondylosis.Even if the spinal cord compression is relieved by surgery,some patients have poor recovery of limb function,which may be related to the brain plasticity alteration induced by long-term lack of sensory input and motor output due to spinal cord compression.This article reviews the recent progress on the brain plasticity of CSM by using functional magnetic resonance imaging(fMRI).It has been demonstrated that patients with CSM have brain plasticity alteration in local brain activity,function connectivity between brain regions,topological properties of brain networks and diffusion properties of white matter,which are related to thesymptoms and prognosis of patients.In addition to the cervical decompression surgery,modulation of brain reorganization should be involved in the treatment of CSM.Neuromodulation therapy from the perspective of brain function might be important for improving short-term and long-term rehabilitation efficacy.

关 键 词：脊髓型颈椎病 功能磁共振成像 脑重塑 

分 类 号：R445.2[医药卫生—影像医学与核医学]