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Neuroradiology · 2026

Investigation of cerebellar structure and static and dynamic functional connectivity in cervical spondylotic myelopathy patients.

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Liu Meng, Xu Siya, Zeng Xianjun, He Laichang, Tan Yongming

Аннотация

PURPOSE: To investigate cerebellar structural and functional alterations in cervical spondylotic myelopathy (CSM) using multimodal MRI.

METHODS: 127 CSM patients and 91 healthy controls (HCs) underwent resting-state fMRI. Gray matter volume (GMV), static functional connectivity (sFC), and dynamic functional connectivity (dFC) were analyzed across 34 cerebellar subregions using the spatially unbiased infratentorial template (SUIT) atlas. Associations between altered imaging metrics and clinical measures were assessed.

RESULTS: (1) CSM patients showed reduced GMV in left lobule V and vermal Crus I compared with HCs; however, these GMV reductions were not significantly associated with clinical measures (all P > 0.05). (2) Widespread cerebello-cerebral sFC alterations were observed in CSM patients, mainly involving interactions between the sensorimotor network (SMN) and default mode network (DMN), visual network (VN) interactions, dorsal attention network (DAN)-DMN/frontoparietal network (FPN) interactions, and deep nuclei-SMN/FPN interactions. The strength of specific sFC connections correlated with motor function and anxiety in CSM patients. (3) Cerebello-cerebral dFC analysis revealed network-dependent alterations in temporal variability, including increased variability in DAN-DMN/FPN, DMN/FPN-VN, and SMN-multiple association and VN pathways, and decreased variability in VN-DMN/FPN pathways. The temporal variability of specific dFC connections correlated with cognitive function.

CONCLUSION: CSM is associated with cerebellar atrophy and widespread alterations in cerebello-cerebral sFC and dFC. Some of these alterations were associated with clinical measures, providing evidence for cerebellar-cerebral network involvement in CSM, although their functional significance requires further clarification.

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