Please use this identifier to cite or link to this item: https://doi.org/10.1155/2015/389531
Title: Cortical Reorganization Is Associated with Surgical Decompression of Cervical Spondylotic Myelopathy
Authors: Green, A
Cheong, P.W.T
Fook-Chong, S
Tiruchelvarayan, R 
Guo, C.M 
Yue, W.M 
Chen, J
Lo, Y.L 
Keywords: adult
Article
brain mapping
cervical spondylotic myelopathy
clinical article
controlled study
decompression surgery
evoked muscle response
female
functional magnetic resonance imaging
hand function
human
leg disease
male
motor cortex
motor nerve conduction
nerve cell plasticity
pinch strength
reflex
transcranial magnetic stimulation
anatomy and histology
biomechanics
brain cortex
hand strength
middle aged
motor evoked potential
nerve conduction
pathology
psychomotor performance
spondylosis
Cerebral Cortex
Decompression, Surgical
Evoked Potentials, Motor
Female
Hand Strength
Humans
Lifting
Male
Middle Aged
Neural Conduction
Neuronal Plasticity
Psychomotor Performance
Spondylosis
Transcranial Magnetic Stimulation
Issue Date: 2015
Citation: Green, A, Cheong, P.W.T, Fook-Chong, S, Tiruchelvarayan, R, Guo, C.M, Yue, W.M, Chen, J, Lo, Y.L (2015). Cortical Reorganization Is Associated with Surgical Decompression of Cervical Spondylotic Myelopathy. Neural Plasticity 2015 : 389531. ScholarBank@NUS Repository. https://doi.org/10.1155/2015/389531
Rights: Attribution 4.0 International
Abstract: Background. Cervical spondylotic myelopathy (CSM) results in sensorimotor limb deficits, bladder, and bowel dysfunction, but mechanisms underlying motor plasticity changes before and after surgery are unclear. Methods. We studied 24 patients who underwent decompression surgery and 15 healthy controls. Patients with mixed upper and lower limb dysfunction (Group A) and only lower limb dysfunction (Group B) were then analysed separately. Results. The sum amplitude of motor evoked potentials sMEP (p<0.01) and number of focal points where MEPs were elicited (N) (p<0.001) were significantly larger in CSM patients compared with controls. For Group A (16 patients), sMEP (p<0.01) and N (p<0.001) showed similar findings. However, for Group B (8 patients), only N (p=0.03) was significantly larger in patients than controls. Group A had significantly increased grip strength (p=0.02) and reduced sMEP (p=0.001) and N (p=0.003) after surgery. Changes in sMEP (cMEP) significantly correlated inversely with improved feeding (p=0.03) and stacking (p=0.04) times as was the change in number of focal points (NDiff) with improved writing times (p=0.03). Group B did not show significant reduction in sMEP or N after surgery, or significant correlation of cMEP or NDiff with all hand function tests. No significant differences in H reflex parameters obtained from the flexor carpi radialis, or central motor conduction time changes, were noted after surgery. Discussion. Compensatory expansion of motor cortical representation occurs largely at cortical rather than spinal levels, with a tendency to normalization after surgery. These mirrored improvements in relevant tasks requiring utilization of intrinsic hand muscles. © 2015 Andrew Green et al.
Source Title: Neural Plasticity
URI: https://scholarbank.nus.edu.sg/handle/10635/183595
ISSN: 20905904
DOI: 10.1155/2015/389531
Rights: Attribution 4.0 International
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