{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T15:24:39Z","timestamp":1794324279710,"version":"4.9.0"},"reference-count":84,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>The physiological mechanisms underlying the recovery of motor function after cervical spondylotic myelopathy (CSM) surgery are poorly understood. Neuronal plasticity allows neurons to compensate for injury and disease and to adjust their activities in response to new situations or changes in their environment. Cortical reorganization as well as improvement in corticospinal conduction happens during motor recovery after stroke and spinal cord injury. In this study the authors aimed to understand the cortical changes that occur due to CSM and following CSM surgery and to correlate these changes with functional recovery by using blood oxygen level\u2013dependent (BOLD) functional MRI (fMRI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Twenty-two patients having symptoms related to cervical cord compression due to spondylotic changes along with 12 age- and sex-matched healthy controls were included in this study. Patients underwent cervical spine MRI and BOLD fMRI at 1 month before surgery (baseline) and 6 months after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Five patients were excluded from analysis because of technical problems; thus, 17 patients made up the study cohort. The mean overall modified Japanese Orthopaedic Association score improved in patients following surgery. Mean upper-extremity, lower-extremity, and sensory scores improved significantly. In the preoperative patient group the volume of activation (VOA) was significantly higher than that in controls. The VOA after surgery was reduced as compared with that before surgery, although it remained higher than that in the control group. In the preoperative patient group, activations were noted only in the left precentral gyrus (PrCG). In the postoperative group, activations were seen in the left postcentral gyrus (PoCG), as well as the PrCG and premotor and supplementary motor cortices. In postoperative group, the VOA was higher in both the PrCG and PoCG as compared with those in the control group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>There is over-recruitment of sensorimotor cortices during nondexterous relative to dexterous movements before surgery. After surgery, there was recruitment of other cortical areas such as the PoCG and premotor and supplementary motor cortices, which correlated with improvement in dexterity, but activation in these areas was greater than that found in controls. The results show that improvement in dexterity and finer movements of the upper limbs is associated with recruitment areas other than the premotor cortex to compensate for the damage in the cervical spinal cord.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2016.3.focus1635","type":"journal-article","created":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T03:53:12Z","timestamp":1464753192000},"page":"E2","source":"Crossref","is-referenced-by-count":41,"title":["Functional cortical reorganization in cases of cervical spondylotic myelopathy and changes associated with surgery"],"prefix":"10.3171","volume":"40","author":[{"given":"Indira Devi","family":"Bhagavatula","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhaval","family":"Shukla","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nishanth","family":"Sadashiva","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Saligoudar","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrajit","family":"Prasad","sequence":"additional","affiliation":[{"name":"Neuroimaging and Interventional Radiology, National Institute of Mental Health and Neurosciences, Bangalore, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhananjaya I.","family":"Bhat","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus1635","series-title":"J Neurol","first-page":"455","article-title":"Plasticity of the spinal cord contributes to neurological improvement after treatment by cervical decompression. A magnetic resonance imaging study","volume":"244","author":"Baba","year":"1997"},{"key":"b2-focus1635","series-title":"Spine (Phila Pa 1976)","first-page":"1219","article-title":"A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate","volume":"28","author":"Baskin","year":"2003"},{"key":"b3-focus1635","series-title":"Top Stroke Rehabil","first-page":"1","article-title":"Plasticity and reorganization of the uninjured brain","volume":"12","author":"Bayona","year":"2005"},{"key":"b4-focus1635","series-title":"Neurobiol Learn Mem","first-page":"33","article-title":"Norepinephrine and neural plasticity: the effects of xylamine on experience-induced changes in brain weight, memory, and behavior","volume":"63","author":"Benloucif","year":"1995"},{"key":"b5-focus1635","series-title":"Brain Res","first-page":"278","article-title":"Long-term changes in motor cortical organisation after recovery from subcortical stroke","volume":"889","author":"Byrnes","year":"2001"},{"key":"b6-focus1635","series-title":"J Neurosurg Spine","first-page":"562","article-title":"Effect of spinal cord signal intensity changes on clinical outcome after surgery for cervical spondylotic myelopathy","volume":"11","author":"Chatley","year":"2009"},{"key":"b7-focus1635","series-title":"Electroencephalogr Clin Neurophysiol","first-page":"438","article-title":"Post-stroke reorganization of brain motor output to the hand: a 2\u20134 month follow-up with focal magnetic transcranial stimulation","volume":"105","author":"Cicinelli","year":"1997"},{"key":"b8-focus1635","series-title":"Brain","first-page":"2941","article-title":"Brain motor system function after chronic, complete spinal cord injury","volume":"128","author":"Cramer","year":"2005"},{"key":"b9-focus1635","series-title":"Brain Res","first-page":"19","article-title":"Absence of localized grey matter volume changes 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after surgical decompression in cervical spondylotic myelopathy","volume":"9","author":"Dong","year":"2008"},{"key":"b14-focus1635","series-title":"Neurology","first-page":"1048","article-title":"Brain reorganization in patients with spinal cord compression evaluated using fMRI","volume":"74","author":"Duggal","year":"2010"},{"key":"b15-focus1635","series-title":"Trends Neurosci","first-page":"410","article-title":"Activity-dependent plasticity: implications for recovery after spinal cord injury","volume":"31","author":"Dunlop","year":"2008"},{"key":"b16-focus1635","series-title":"J Neurosurg Spine","first-page":"97","article-title":"Surgical management of cervical degenerative disease: the evidence related to indications, impact, and outcome","volume":"11","author":"Fehlings","year":"2009"},{"issue":"3","key":"b17-focus1635","series-title":"Cochrane Database Syst Rev","first-page":"CD001466","article-title":"Surgery for cervical 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injury","volume":"58","author":"Mikulis","year":"2002"},{"issue":"1","key":"b34-focus1635","series-title":"Cochrane Database Syst Rev","first-page":"CD001466","article-title":"Surgery for cervical radiculopathy or myelopathy","author":"Nikolaidis","year":"2010"},{"key":"b35-focus1635","series-title":"Science","first-page":"1150","article-title":"Time-dependent central compensatory mechanisms of finger dexterity after spinal cord injury","volume":"318","author":"Nishimura","year":"2007"},{"key":"b36-focus1635","series-title":"J Bone Joint Surg Am","first-page":"1619","article-title":"Operative treatment of cervical spondylotic myelopathy","volume":"88","author":"Rao","year":"2006"},{"key":"b37-focus1635","series-title":"Spine (Phila Pa 1976)","first-page":"670","article-title":"Outcome of patients treated for cervical myelopathy. 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A magnetic resonance imaging study","volume":"244","author":"Baba","year":"1997"},{"key":"b2-focus1635","series-title":"Spine (Phila Pa 1976)","first-page":"1219","article-title":"A prospective, randomized, controlled cervical fusion study using recombinant human bone morphogenetic protein-2 with the CORNERSTONE-SR allograft ring and the ATLANTIS anterior cervical plate","volume":"28","author":"Baskin","year":"2003"},{"key":"b3-focus1635","series-title":"Top Stroke Rehabil","first-page":"1","article-title":"Plasticity and reorganization of the uninjured brain","volume":"12","author":"Bayona","year":"2005"},{"key":"b4-focus1635","series-title":"Neurobiol Learn Mem","first-page":"33","article-title":"Norepinephrine and neural plasticity: the effects of xylamine on experience-induced changes in brain weight, memory, and behavior","volume":"63","author":"Benloucif","year":"1995"},{"key":"b5-focus1635","series-title":"Brain Res","first-page":"278","article-title":"Long-term changes in motor cortical organisation after recovery from subcortical stroke","volume":"889","author":"Byrnes","year":"2001"},{"key":"b6-focus1635","series-title":"J Neurosurg Spine","first-page":"562","article-title":"Effect of spinal cord signal intensity changes on clinical outcome after surgery for cervical spondylotic myelopathy","volume":"11","author":"Chatley","year":"2009"},{"key":"b7-focus1635","series-title":"Electroencephalogr Clin Neurophysiol","first-page":"438","article-title":"Post-stroke reorganization of brain motor output to the hand: a 2\u20134 month follow-up with focal magnetic transcranial stimulation","volume":"105","author":"Cicinelli","year":"1997"},{"key":"b8-focus1635","series-title":"Brain","first-page":"2941","article-title":"Brain motor system function after chronic, complete spinal cord injury","volume":"128","author":"Cramer","year":"2005"},{"key":"b9-focus1635","series-title":"Brain Res","first-page":"19","article-title":"Absence of localized grey matter volume changes in the motor cortex following spinal cord injury","volume":"1028","author":"Crawley","year":"2004"},{"key":"b10-focus1635","series-title":"Brain","first-page":"2567","article-title":"Changes of non-affected upper limb cortical representation in paraplegic patients as assessed by fMRI","volume":"125","author":"Curt","year":"2002"},{"key":"b11-focus1635","series-title":"J Neurotrauma","first-page":"43","article-title":"Differential effect of spinal cord injury and functional impairment on human brain activation","volume":"19","author":"Curt","year":"2002"},{"key":"b12-focus1635","series-title":"Neurorehabil Neural Repair","first-page":"3","article-title":"Confounders in rehabilitation trials of task-oriented training: lessons from the designs of the EXCITE and SCILT multicenter trials","volume":"21","author":"Dobkin","year":"2007"},{"key":"b13-focus1635","series-title":"J Neurosurg Spine","first-page":"538","article-title":"Compensatory cerebral adaptations before and evolving changes after surgical decompression in cervical spondylotic myelopathy","volume":"9","author":"Dong","year":"2008"},{"key":"b14-focus1635","series-title":"Neurology","first-page":"1048","article-title":"Brain reorganization in patients with spinal cord compression evaluated using fMRI","volume":"74","author":"Duggal","year":"2010"},{"key":"b15-focus1635","series-title":"Trends Neurosci","first-page":"410","article-title":"Activity-dependent plasticity: implications for recovery after spinal cord injury","volume":"31","author":"Dunlop","year":"2008"},{"key":"b16-focus1635","series-title":"J Neurosurg Spine","first-page":"97","article-title":"Surgical management of cervical degenerative disease: the evidence related to indications, impact, and outcome","volume":"11","author":"Fehlings","year":"2009"},{"issue":"3","key":"b17-focus1635","series-title":"Cochrane Database Syst Rev","first-page":"CD001466","article-title":"Surgery for cervical radiculomyelopathy","author":"Fouyas","year":"2001"},{"issue":"10 Suppl","key":"b18-focus1635","series-title":"Spine (Phila Pa 1976)","first-page":"S534","article-title":"Magnetic resonance imaging study on spinal cord plasticity in patients with cervical compression myelopathy","volume":"16","author":"Fukushima","year":"1991"},{"key":"b19-focus1635","series-title":"Neural Plast","first-page":"389531","article-title":"Cortical reorganization is associated with surgical decompression of cervical spondylotic myelopathy","volume":"2015","author":"Green","year":"2015"},{"key":"b20-focus1635","series-title":"J Neurosci","first-page":"3284","article-title":"Topographic organization of corticospinal projections from the frontal lobe: motor areas on the medial surface of the hemisphere","volume":"15","author":"He","year":"1995"},{"key":"b21-focus1635","series-title":"Neurosurgery","first-page":"1101","article-title":"Stretch-associated injury in cervical spondylotic myelopathy: new concept and 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myelopathy","volume":"25","author":"Ishii","year":"2012"},{"key":"b26-focus1635","series-title":"Brain","first-page":"2731","article-title":"Correlation between motor improvements and altered fMRI activity after rehabilitative therapy","volume":"125","author":"Johansen-Berg","year":"2002"},{"key":"b27-focus1635","series-title":"Neurology","first-page":"762","article-title":"Somatosensory cortical atrophy after spinal cord injury: a voxel-based morphometry study","volume":"66","author":"Jurkiewicz","year":"2006"},{"key":"b28-focus1635","series-title":"Neurorehabil Neural Repair","first-page":"527","article-title":"Sensorimotor cortical plasticity during recovery following spinal cord injury: a longitudinal fMRI study","volume":"21","author":"Jurkiewicz","year":"2007"},{"key":"b29-focus1635","series-title":"J Neurotrauma","first-page":"2113","article-title":"Reorganization and preservation of motor control of the brain in spinal cord injury: a systematic 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