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Central Nervous System Changes in Asymptomatic Spinal Cord Compression and Surgical Outcome Prediction
Central Nervous System Changes in Asymptomatic Spinal Cord Compression and Surgical Outcom...
Central Nervous System Changes in Asymptomatic Spinal Cord Compression and Surgical Outcome Prediction

Detailed Information

자료유형  
 학위논문 서양
최종처리일시  
20260202104714
ISBN  
9798288806698
DDC  
616
저자명  
Kostiuk, Alexander Kulchycky.
서명/저자  
Central Nervous System Changes in Asymptomatic Spinal Cord Compression and Surgical Outcome Prediction
발행사항  
[Sl] : University of California, Los Angeles, 2025
발행사항  
Ann Arbor : ProQuest Dissertations & Theses, 2025
형태사항  
82 p
주기사항  
Source: Dissertations Abstracts International, Volume: 87-01, Section: B.
주기사항  
Advisor: Ellingson, Benjamin M.
학위논문주기  
Thesis (Ph.D.)--University of California, Los Angeles, 2025.
초록/해제  
요약The goal of this thesis was to investigate the patterns of functional and structural connectivity in patients with asymptomatic cervical spinal cord compression (ASCC) compared to healthy controls (HCs) and use these patterns to predict surgical outcome in degenerative cervical myelopathy (DCM) patients.These studies consisted of 45 ASCC patients, 35 HCs, and 42 DCM patients with resting-state functional MRI (rs-fMRI) and diffusion tensor imaging (DTI) scans. The ASCC patients also had sagittal and axial T2-weighted cervical spinal MR imaging. Brain images were parcellated into regions-of-interest (ROIs) using the Montreal Neurological Institute (MNI) atlas and Multi-Domain Task Battery (MDTB) atlas. Correlation between rs-fMRI in ROIs was used to measure strength of functional connectivity, while streamline number from probabilistic tractography and fractional anisotropy (FA) were used to measure structural connectivity.ASCC patients had stronger functional and structural connectivity between visual and motor regions when compared to HCs, with the intracalcarine cortex (occipital cortex) being the largest hub of connection strength differences. Pre-surgical measures of functional and structural connectivity in the five connections with the greatest difference between ASCC patients and HCs were able to predict which DCM patients would experience the greatest benefit from spinal decompression surgery. This thesis indicates that functional and structural brain changes are already evident before neurological symptoms are seen. These alterations in connectivity patterns reflect a systematic reorganization of neural dynamics, suggesting the brain adaptively reconfigures its computational architecture to compensate for compromised signal transmission through the compressed spinal cord. ASCC patients appear to rely more on visual information to maintain normal sensorimotor function as proprioception information is likely compromised due to spinal compression. These early adaptations in brain computation may serve as crucial biomarkers for disease progression, potentially enabling more precise timing of clinical interventions in this challenging patient population. Finally, the finding that the same brain network changes in ASCC patients are also predictive of surgical outcome in DCM patients suggests there is a set of brain connections that define a core of adaptations the brain uses over multiple stages of this disease. The state of these connections could prove highly useful for clinicians in deciding when and if patients should be recommended for surgical intervention.
일반주제명  
Neurosciences
일반주제명  
Health sciences
일반주제명  
Surgery
키워드  
Asymptomatic spinal cord compression
키워드  
Degenerative cervical myelopathy
키워드  
Tractography
기타저자  
University of California, Los Angeles Neuroscience 004F
기본자료저록  
Dissertations Abstracts International. 87-01B.
전자적 위치 및 접속  
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MARC

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■040    ▼aMiAaPQ▼cMiAaPQ
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■1001  ▼aKostiuk,  Alexander  Kulchycky.
■24510▼aCentral  Nervous  System  Changes  in  Asymptomatic  Spinal  Cord  Compression  and  Surgical  Outcome  Prediction
■260    ▼a[Sl]▼bUniversity  of  California,  Los  Angeles▼c2025
■260  1▼aAnn  Arbor▼bProQuest  Dissertations  &  Theses▼c2025
■300    ▼a82  p
■500    ▼aSource:  Dissertations  Abstracts  International,  Volume:  87-01,  Section:  B.
■500    ▼aAdvisor:  Ellingson,  Benjamin  M.
■5021  ▼aThesis  (Ph.D.)--University  of  California,  Los  Angeles,  2025.
■520    ▼aThe  goal  of  this  thesis  was  to  investigate  the  patterns  of  functional  and  structural  connectivity  in  patients  with  asymptomatic  cervical  spinal  cord  compression  (ASCC)  compared  to  healthy  controls  (HCs)  and  use  these  patterns  to  predict  surgical  outcome  in  degenerative  cervical  myelopathy  (DCM)  patients.These  studies  consisted  of  45  ASCC  patients,  35  HCs,  and  42  DCM  patients  with  resting-state  functional  MRI  (rs-fMRI)  and  diffusion  tensor  imaging  (DTI)  scans.  The  ASCC  patients  also  had  sagittal  and  axial  T2-weighted  cervical  spinal  MR  imaging.  Brain  images  were  parcellated  into  regions-of-interest  (ROIs)  using  the  Montreal  Neurological  Institute  (MNI)  atlas  and  Multi-Domain  Task  Battery  (MDTB)  atlas.  Correlation  between  rs-fMRI  in  ROIs  was  used  to  measure  strength  of  functional  connectivity,  while  streamline  number  from  probabilistic  tractography  and  fractional  anisotropy  (FA)  were  used  to  measure  structural  connectivity.ASCC  patients  had  stronger  functional  and  structural  connectivity  between  visual  and  motor  regions  when  compared  to  HCs,  with  the  intracalcarine  cortex  (occipital  cortex)  being  the  largest  hub  of  connection  strength  differences.  Pre-surgical  measures  of  functional  and  structural  connectivity  in  the  five  connections  with  the  greatest  difference  between  ASCC  patients  and  HCs  were  able  to  predict  which  DCM  patients  would  experience  the  greatest  benefit  from  spinal  decompression  surgery.  This  thesis  indicates  that  functional  and  structural  brain  changes  are  already  evident  before  neurological  symptoms  are  seen.  These  alterations  in  connectivity  patterns  reflect  a  systematic  reorganization  of  neural  dynamics,  suggesting  the  brain  adaptively  reconfigures  its  computational  architecture  to  compensate  for  compromised  signal  transmission  through  the  compressed  spinal  cord.  ASCC  patients  appear  to  rely  more  on  visual  information  to  maintain  normal  sensorimotor  function  as  proprioception  information  is  likely  compromised  due  to  spinal  compression.  These  early  adaptations  in  brain  computation  may  serve  as  crucial  biomarkers  for  disease  progression,  potentially  enabling  more  precise  timing  of  clinical  interventions  in  this  challenging  patient  population.  Finally,  the  finding  that  the  same  brain  network  changes  in  ASCC  patients  are  also  predictive  of  surgical  outcome  in  DCM  patients  suggests  there  is  a  set  of  brain  connections  that  define  a  core  of  adaptations  the  brain  uses  over  multiple  stages  of  this  disease.  The  state  of  these  connections  could  prove  highly  useful  for  clinicians  in  deciding  when  and  if  patients  should  be  recommended  for  surgical  intervention.
■590    ▼aSchool  code:  0031.
■650  4▼aNeurosciences
■650  4▼aHealth  sciences
■650  4▼aSurgery
■653    ▼aAsymptomatic  spinal  cord  compression
■653    ▼aDegenerative  cervical  myelopathy
■653    ▼aTractography
■690    ▼a0317
■690    ▼a0576
■690    ▼a0566
■71020▼aUniversity  of  California,  Los  Angeles▼bNeuroscience  004F.
■7730  ▼tDissertations  Abstracts  International▼g87-01B.
■790    ▼a0031
■791    ▼aPh.D.
■792    ▼a2025
■793    ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17358523▼nKERIS▼z이  자료의  원문은  한국교육학술정보원에서  제공합니다.

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