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

基本信息

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
项目类别：
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

项目摘要

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.

项目概要/摘要神经根病是一种常见的脊柱疾病，由脊神经根受压和刺激引起，导致感觉缺陷、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和神经系统之间对应关系的信息。皮肤感觉缺陷可以帮助定位脊柱疾病中的神经损伤并指导治疗。然而，皮肤图是有限的——它们在神经解剖学图上包含不确定性（脊髓神经、背根神经节、背角或脊髓 (SC) 段），呈现左右对称且无性别差异，没有提供有关受试者之间变异性的信息，并且仍有待验证 SC 功能。磁共振成像 (fMRI) 可以对人体 SC 活动进行非侵入性体内空间测绘。在这里，我们将使用 SC fMRI 来测试皮瘤图的中心假设，研究以下因素的影响：神经损伤对 SC 感觉处理的影响，开发 SC 感觉活动的标记，并测试其诊断为了实现这一目标，我们首先要增强颈神经根病的价值。我们现有的 SC fMRI 方法通过构建研究级 64 通道头颈线圈来测试一种新颖的空间考虑 SC 段位置的归一化方法，并探索表面的使用我们将比较功能磁共振成像实验期间的肌电图监测和消除运动相关噪声。针对我们当前的操作方法改进了 SC fMRI 方法，同时表征 SC 相关性使用右侧第三个数字的皮电感觉刺激进行感觉刺激强度编码对 30 名健康志愿者（HV）（20-79 岁，15 名女性，15 名男性）进行手部（C7 皮刀）治疗。增强的 SC fMRI 方法，我们将定量绘制 120 个右侧 SC 活动的空间分布图皮电感觉期间的双手 HV（20-79 岁，女性 60 名，男性 60 名，按年龄分层）刺激左侧和右侧的第一、第三和第五指（分别为 C6、C7 和 C8 皮节）我们将绘制 SC 活动空间分布的概率图，评估优劣。活动的定位，对比左右刺激和性别之间的活动，并量化之间 - 我们将使用机器学习算法来开发规范的 SC 感官标记。最后，40 名患有右侧 C7 颈神经根病的右手患者（30- 79 岁（20 名女性、20 名男性）和 40 名年龄和性别匹配的 HV 也将接受相同的 SC fMRI 实验，我们将研究 SC 活动的组间差异，以揭示神经损伤的影响 SC 感觉处理，然后评估 SC 感觉标记的诊断价值。目标将改进 SC fMRI 方法，验证/反驳皮瘤图的核心假设，以更好地提供信息它们在临床实践中的应用，提高了我们对健康和受伤的 SC 感觉处理的科学知识状态，并提供基于 MRI 的颈神经根病诊断标志物的初步验证。