Dermatomal Mapping with Spinal Cord Functional Magnetic Resonance Imaging

使用脊髓功能磁共振成像进行皮区标测

• 批准号: 10720645
• 负责人: Kenneth Arnold Weber
• 金额: $ 58.79万
• 依托单位: STANFORD UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2028-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10720645
• 关键词: Acceleration; Affect; Age; Brain; Cervical Radiculopathies; Classification; Clinical; Clinical assessments; Cutaneous; Digit structure; Electromyography; Esthesia; Excision; Female; Functional Magnetic Resonance Imaging; Goals; Hand; Head and neck structure; Human; Image; Image Analysis; Individual; Inferior; Injury; Interdisciplinary Study; Knowledge; Left; Location; Magnetic Resonance Imaging; Maps; Methods; Monitor; Motor; Muscle Weakness; Nerve; Nervous System; Nervous System Trauma; Neuroanatomy; Neurologic Effect; Noise; Pain; Patients; Radiculopathy; Research; Resolution; Sensitivity and Specificity; Sensory; Severities; Sex Differences; Side; Signal Transduction; Site; Spatial Distribution; Spinal; Spinal Cord; Spinal Ganglia; Spinal nerve root structure; Spinal nerve structure; Stimulus; Surface; Testing; Uncertainty; Upper Extremity; Validation; Vertebral column; Work; age stratification; clinical examination; clinical practice; dermatome; diagnostic biomarker; diagnostic value; dorsal horn; experimental study; healthy volunteer; improved; in vivo; injured; irritation; machine learning algorithm; male; neural; novel; open source; physically handicapped; predictive marker; sensory stimulus; sex; spinal cord imaging; spinal cord mapping; tool

PROJECT SUMMARY/ABSTRACT Radiculopathy is a common spinal condition resulting from compression and irritation of the spinal nerve roots, leading to sensory deficits, muscle weakness, and pain. Dermatomal maps are a key component of the clinical exam and provide information on the correspondence between cutaneous sensations and the nervous system. Dermatomal sensory deficits can help localize neurological injury in spinal conditions and guide treatment. Dermatomal maps, however, are limited—they contain uncertainty in the neuroanatomy mapped (spinal nerve, dorsal root ganglion, dorsal horn, or spinal cord (SC) segment), assume left-right symmetry and no sex differences, provide no information on between-subject variability, and remain to be validated. SC functional magnetic resonance imaging (fMRI) permits the non-invasive in vivo spatial mapping of human SC activity. Here we will use SC fMRI to test hypotheses central to dermatomal maps, investigate the effects of neurological injury on SC sensory processing, develop markers of SC sensory activity, and test their diagnostic value in cervical radiculopathy while improving our SC fMRI methods. To accomplish this, we will first enhance our existing SC fMRI methods by building a research-grade 64-channel head-neck coil, testing a novel spatial normalization method that accounts for SC segment location, and exploring the use of surface electromyography to monitor and remove motor-related noise during fMRI experiments. We will compare the improved SC fMRI methods against our currently operational methods while characterizing the SC correlates of sensory stimulus intensity encoding using electrocutaneous sensory stimulation of the third digit of the right hand (C7 dermatome) in 30 healthy volunteers (HV) (20-79 years old, 15 females, 15 males). Then using the enhanced SC fMRI methods, we will quantitatively map the spatial distribution of SC activity in 120 right- handed HVs (20-79 years old, 60 females, 60 males, stratified by age) during electrocutaneous sensory stimulation of the first, third, and fifth digits (C6, C7, and C8 dermatomes, respectively) of the left and right hands. We will develop probabilistic maps of the spatial distribution of SC activity, assess the superior-inferior localization of activity, contrast the activity between left and right stimulation and sexes, and quantify between- subject variability. We will use machine learning algorithms to develop normative SC sensory markers by predicting the stimulation site. Finally, 40 right-handed patients with right-sided C7 cervical radiculopathy (30– 79 years old, 20 females, 20 males) and 40 age- and sex-matched HVs will also undergo the same SC fMRI experiment, and we will investigate group differences in SC activity to uncover the effects of neurological injury on SC sensory processing and then assess the diagnostic value of the SC sensory markers. Completing our aims will improve SC fMRI methods, validate/refute hypotheses central to dermatomal maps to better inform their use in clinical practice, advance our scientific knowledge of SC sensory processing in healthy and injured states, and provide preliminary validation of MRI-based diagnostic markers for cervical radiculopathy.

项目摘要/摘要 radiculopathy是由脊髓根部压缩和刺激引起的常见脊柱疾病， 导致感觉不足，肌肉无力和疼痛。皮肤图是临床的关键组成部分 检查并提供有关皮肤感觉与神经系统之间对应关系的信息。 皮肤感觉定义可以帮助脊柱条件下的神经系统损伤和指导治疗。 但是，皮肤图受到限制 - 它们包含神经解剖学映射的不确定性（脊神经， 背根神经节，背角或脊髓（SC）段）假设左右对称性，没有性别 差异，没有提供有关受试者间变异性的信息，并保持待验证。 SC功能 磁共振成像（fMRI）允许人类SC活性的非侵入性体内空间映射。 在这里，我们将使用SC fMRI来测试皮肤图中心的假设，研究 SC感官处理，开发SC感官活动的标记并测试其诊断的神经损伤 在改善我们的SC fMRI方法的同时，宫颈辐射病的价值。为此，我们将首先增强 我们现有的SC fMRI方法通过构建研究级64通道头颈线圈，测试一个新型的空间 说明SC段位置并探索表面的使用的标准化方法 在功能磁共振成像实验期间，肌电图监测和消除与运动相关的噪声。我们将比较 改进了针对我们当前操作方法的SC fMRI方法，而表征SC相关 使用右第三位数字的电视感觉刺激编码的感觉刺激强度 30名健康志愿者（HV）（20-79岁，15位女性，15名男性）的手（C7皮肤病）。然后使用 增强的SC fMRI方法，我们将在120个右 - 在电态感觉期间，手工HVS（20-79岁，60名女性，60名男性，按年龄分层） 左右刺激第一，第三和第五位（分别为C6，C7和C8皮肤病） 手。我们将开发SC活性空间分布的概率图，评估上部 活动的定位，对比左右模拟与性别之间的活性，并量化 主题可变性。我们将使用机器学习算法来开发正常的SC感官标记 预测刺激部位。最后，40例右侧C7宫颈radiculopathy患者（30– 79岁，20名女性，20名男性）和40岁和性别匹配的HV也将接受相同的SC fMRI 实验，我们将研究SC活性的群体差异，以发现神经损伤的影响 在SC感官处理上，然后评估SC感官标记的诊断值。完成我们的 AIMS将改善SC fMRI方法，验证/驳斥假设皮肤图中心以更好地告知 它们在临床实践中的使用，提高我们对健康和受伤的SC感官处理的科学知识 状态，并提供基于MRI的诊断标记的宫颈辐射病的初步验证。