Network Centrality Alterations In Patients With Cervical Spondylotic Myelopathy

Objective:The aim of this study was to investigate the changes of the whole brain functional network activity in patients with cervical spondylotic myelopathy from the perspective of voxel-wise degree centrality and its relationship with their clinical manifestations.Methods:We recruited 38 patients with CSM(30 mild-moderate CSM,8 severe CSM),and20 healthy controls(HC)matched for age,sex and education status.Disease severity was quantified by the Japanese Orthopaedic Association(JOA)scoring.The DC method was used to evaluate the altered spontaneous brain activities.Further Pearson correlation analysis and receiver operating characteristic(ROC)curves were used to confirm the significance of DC changes in various brain regions.Result:(1)Compared with HC,the two CSM groups exhibited decreased DC in the right anterior cingulate cortex(ACC)and left superior frontal gyrus medial(SFGmed).Moreover,the increased DC was detected in the right inferior frontal gyrus(IFG)and left superrior temporal gyrus(STG).Additionally,CSM group showed abnormal DC in the right precentral gyrus(Pre CG)and superrior occipital gyrus(SOG),tended to increase initially and decrease then during the later period with progressing disease severity.(2)Further correlation analysis and ROC curves revalidate the significance of most of these abnormal brain regions.(3)The DC value of the right Pre CG and left MFG were positively correlated with the JOA score(r=0.548,P<0.001;r=0.328,P=0.045).Conclusions:(1)In this study,it was found that the pattern of intrinsic function network activity in CSM patients reveals certain regularities,which may be a potential neuroimaging marker to monitor the disease progression in patients with CSM.(2)The DC value of abnormal brain areas in CSM patients are correlated with JOA score,which may be the neuroimaging basis for clinical dysfunction in CSM patients.