The Surgical Outcome Validations and Neuroplasticity of Lumbar Spinal Stenosis with Neurogenic Intermittent Claudication by Functional and Structural Mr Imaging Correlation

Lumbar spinal stenosis (LSS) with neurogenic intermittent claudication (NIC) is one of the most commonly diagnosed and treated pathological spinal conditions that frequently afflicts the elderly population. Neurogenic claudication can have a significant impact on functional ability, quality of life and independence in the elderly. The etiology of NIC is thought to be compression and/or ischemia of the lumbosacral nerve roots. However, the pathomechanism of NIC still remains obscure thus far and needs further explorations. Recent in vivo anatomical and functional MR imaging studies in humans are beginning to shed highlights on the brain re-organization (also known as neuroplasticity) associated with chronic pain. Cumulative evidences from functional MRI (fMRI) study had pointed out the existence of brain activity change in patients with chronic low back pain. Furthermore, by structural MRI study brain morphology alteration in areas related to pain processing are also detected in patients with chronic back pain, fibromyalgia, or complex regional pain syndrome. These revolutionary and important findings indicate that pain is not only a local norciception disorder but also has an impact on central nervous system, both functional and morphological. Literature notes that the relationship of NIC and brain neuroplasticity has not ever been reported. The effects of disease duration and severity of LSS with NIC on brain functional and structural changes are little understood. The specific aims of this proposal are (1) Establishment of using a lumbar spinal MR imaging stenotic predictors to correlate with the severity of NIC and surgical outcomes; (2) Correlating the MR predictors and outcomes between two groups with alteration of sensorimotor function detected by fMRI both pre- and post-operatively; (3) Using structural MRI such as VBM, DTI and resting-state fcMRI to detect the alteration and reversibility of brain structure and functional connectivity of LSS with NIC patients both initial and longitudinal changes. The long-term goal of this study may provide a better understanding in the pathomechanism of NIC, the surgical indication of NIC and its potential impact on brain function and/or structure.

Project ID:PC10107-0348
External Project ID:NSC101-2314-B182A-107