Sensorimotor network ALFF markers as prognostic indicators of cervical spondylotic myelopathy post-decompression surgery outcomes

Purpose: To investigate the prognostic value of amplitude of low-frequency fluctuations (ALFF) within the sensorimotor network (SMN) in patients with cervical spondylotic myelopathy (CSM) following decompression surgery. Methods: Eighty-three presurgical CSM patients (pre-CSM), 60 of the same group followed-up 3 months after decompression surgery (post-CSM) and 83 healthy controls (HC) matched for age, sex and level of education underwent resting-state functional magnetic resonance imaging scans by 3.0 T MR. Then, ALFF values measurements were compared and ALFF alterations were assessed among pre- or postsurgical CSM patients and HC, as well as correlations with clinical indexes by Pearson correlation. Results: Compared with HC, the ALFF value of left inferior parietal marginal angular gyrus was decreased and the bilateral medial frontal gyrus was increased within pre-CSM (GRF correction). Compared with HC, the ALFF values of the left precentral gyrus, superior marginal gyrus, inferior parietal marginal angular gyrus, parietal lobule and postcentral gyrus decreased, while the ALFF value of the left auxiliary motor area, right anterior cuneiform lobule and right parietal lobule increased within post-CSM. Compared with pre-CSM patients, post-CSM patients had lower ALFF value in bilateral precuneus and precentral gyrus, but increased ALFF value in left medial superior frontal gyrus (Frontal_Sup_Medial_L). The ALFF value of the bilateral precuneus was positively correlated with the mJOA improvement rate, and the ALFF value of Frontal_Sup_Medial_L was positively correlated with the upper and lower limb scores within post-CSM. Conclusion: Functional impairment and plasticity of SMN exist in CSM patients before and after surgery. ALFF within the SMN serves as a potential biomarker for predicting recovery outcomes.