Altered Local Spontaneous Brain Activity in Cervical Spondylotic Myelopathy: A Meta-Analysis

Ruihao Zhang; Wenhuan Yuan; Qirui Yang; Zixuan Lu; Zhihui Zhao; Quannian Shao; Xiaobo Zhang; Wenji Wang

doi:10.1016/j.wneu.2025.124599

Altered Local Spontaneous Brain Activity in Cervical Spondylotic Myelopathy: A Meta-Analysis

World Neurosurg. 2025 Nov 7:205:124599. doi: 10.1016/j.wneu.2025.124599. Online ahead of print.

Authors

Ruihao Zhang¹, Wenhuan Yuan², Qirui Yang³, Zixuan Lu⁴, Zhihui Zhao³, Quannian Shao⁵, Xiaobo Zhang⁶, Wenji Wang⁷

Affiliations

¹ The First Clinical Medical College of Lanzhou University, Lanzhou, PR China; Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, PR China.
² Department of Magnetic Resonance Imaging, Lanzhou University Second Hospital, Lanzhou, PR China.
³ The First Clinical Medical College of Lanzhou University, Lanzhou, PR China.
⁴ School of Basic Medical Sciences, Lanzhou University, Lanzhou, PR China.
⁵ Department of Gynecology, The First Hospital of Lanzhou University, Lanzhou, PR China.
⁶ Department of Spine Surgery, Honghui Hospital, Xi'an JiaoTong University, Xi'an, Shaanxi, China.
⁷ The First Clinical Medical College of Lanzhou University, Lanzhou, PR China; Department of Orthopedics, The First Hospital of Lanzhou University, Lanzhou, PR China. Electronic address: ldyyspinewwj@163.com.

PMID: 41205862
DOI: 10.1016/j.wneu.2025.124599

Abstract

Objective: This meta-analysis aimed to identify consistent alterations in local spontaneous brain activity in patients with cervical spondylotic myelopathy (CSM) by synthesizing findings from resting-state functional magnetic resonance imaging studies and to explore potential neural mechanisms underlying this condition.

Materials and methods: A systematic literature search was conducted for studies published up to March 2025 that utilized regional homogeneity, amplitude of low-frequency fluctuations, or fractional amplitude of low-frequency fluctuations to investigate resting-state brain activity alterations in CSM. Coordinates of brain regions exhibiting differential local spontaneous brain activity in CSM patients compared to healthy controls were extracted from the included studies. A meta-analysis was subsequently performed using seed-based d mapping software. This study protocol was registered prospectively with PROSPERO (ID: CRD42025640418).

Results: Eight studies, encompassing 252 CSM patients (122 males, 130 females) and 230 healthy controls (109 males, 121 females), met the inclusion criteria. The meta-analysis revealed that, compared to healthy controls, CSM patients exhibited significantly increased local spontaneous brain activity in the Frontal_Sup_Medial_R and Cingulum_Mid_R. Conversely, decreased activity was observed in the Lingual_R, Paracentral_Lobule_L, Rolandic_Oper_R, and Postcentral_L. Furthermore, meta-regression analysis indicated a positive correlation between Japanese Orthopedic Association scores and activity in the right medial superior frontal gyrus, and negative correlations with activity in the right postcentral gyrus and right central operculum.

Conclusion: This meta-analysis confirms consistent patterns of altered local spontaneous brain function in specific regions among patients with CSM, which potentially correlate with their clinical symptoms. These findings provide valuable insights into the pathophysiology of CSM, thereby informing future clinical research and the development of novel therapeutic strategies.

Keywords: Cervical spondylotic myelopathy; Local spontaneous brain activity; Meta-analysis.

Publication types

Review