{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T16:25:05Z","timestamp":1789230305904,"version":"build-2803163510"},"reference-count":53,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neural Plasticity"],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p><jats:italic>Background<\/jats:italic>. 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.<jats:italic>Methods<\/jats:italic>. 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.<jats:italic>Results<\/jats:italic>. The sum amplitude of motor evoked potentials sMEP (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>) and number of focal points where MEPs were elicited (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mrow><mml:mi>N<\/mml:mi><\/mml:mrow><\/mml:math>) (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>) were significantly larger in CSM patients compared with controls. For Group A (16 patients), sMEP (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.01<\/mml:mn><\/mml:math>) and<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mrow><mml:mi>N<\/mml:mi><\/mml:mrow><\/mml:math>(<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>p<\/mml:mi><mml:mo>&lt;<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>) showed similar findings. However, for Group B (8 patients), only<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mrow><mml:mi>N<\/mml:mi><\/mml:mrow><\/mml:math>(<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.03<\/mml:mn><\/mml:math>) was significantly larger in patients than controls. Group A had significantly increased grip strength (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.02<\/mml:mn><\/mml:math>) and reduced sMEP (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.001<\/mml:mn><\/mml:math>) and<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\"><mml:mrow><mml:mi>N<\/mml:mi><\/mml:mrow><\/mml:math>(<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M12\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.003<\/mml:mn><\/mml:math>) after surgery. Changes in sMEP (cMEP) significantly correlated inversely with improved feeding (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M13\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.03<\/mml:mn><\/mml:math>) and stacking (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M14\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.04<\/mml:mn><\/mml:math>) times as was the change in number of focal points (NDiff) with improved writing times (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M15\"><mml:mi>p<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>0.03<\/mml:mn><\/mml:math>). Group B did not show significant reduction in sMEP or<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M16\"><mml:mrow><mml:mi>N<\/mml:mi><\/mml:mrow><\/mml:math>after surgery, or significant correlation of cMEP or NDiff with all hand function tests. No significant differences in<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M17\"><mml:mrow><mml:mi>H<\/mml:mi><\/mml:mrow><\/mml:math>reflex parameters obtained from the flexor carpi radialis, or central motor conduction time changes, were noted after surgery.<jats:italic>Discussion<\/jats:italic>. 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.<\/jats:p>","DOI":"10.1155\/2015\/389531","type":"journal-article","created":{"date-parts":[[2015,11,2]],"date-time":"2015-11-02T21:05:06Z","timestamp":1446498306000},"page":"1-9","source":"Crossref","is-referenced-by-count":15,"title":["Cortical Reorganization Is Associated with Surgical Decompression of Cervical Spondylotic Myelopathy"],"prefix":"10.1155","volume":"2015","author":[{"given":"Andrew","family":"Green","sequence":"first","affiliation":[{"name":"Duke-NUS Graduate Medical School, 8 College Road, Singapore 169857"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscilia W. 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