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目的：利用静息态fMRI(rs-fMRI)技术，探讨脊髓型颈椎病(CSM)患者解压术前、术后静息状态下大脑感觉运动网络内的局部功能活动改变情况。方法2013年6月至2014年4月收集拟行减压术的CSM患者21例（患者组）及年龄、性别及受教育程度匹配的健康志愿者21名（对照组），所有患者术前及术后3个月均进行rs-fMRI扫描。采用基于局部一致性(ReHo)的方法，计算受试者内源性局部脑功能活动。运用双独立样本t检验比较CSM患者组术前、术后与对照组之间，配对t检验比较患者手术前后大脑感觉运动网络内ReHo的差异。用Pearson相关性分析观察异常区域ReHo值和临床功能评估之间的相关性。结果与健康对照组比较，CSM患者术前静息状态下左侧中央前、后回的ReHo降低（体素数89，t=－3.894，P<0.05），而右侧顶上小叶的ReHo增高(体素数87，t=3.829，P<0.05)。CSM患者术后3个月复查，较健康对照组右侧顶上小叶ReHo减低（体素数320，t=－4.5964，P<0.01），较术前左侧中央前、后回ReHo值升高（体素数372，t=－3.9811，P<0.05）。术前及术后3个月复查时CSM患者组异常ReHo区域与临床功能评分均无相关性(P>0.05)。结论 CSM患者存在感觉运动皮层静息状态下局部功能活动异常，解压术后局部功能活动趋于正常，提示皮质重塑参与CSM术后功能的恢复。

Objective To assess the altered regional homogeneity (ReHo) of local intrinsic cerebral activity within sensorimotor network(SMN) in patients with cervical spondylotic myelopathy (CSM) before or after spinal cord decompression using functional MRI (fMRI). Methods Twenty-one CSM patients who would decompress spinal canal, and 21 healthy volunteers (age, gender and level of education matched) were enrolled from June 2013 to April 2014. All the patients underwent rs-fMRI examination before and 3 months after spinal cord decompression. ReHo measurement was performed statistically within a SMN mask. A second-level random-effect 2-tailed Student's t test was applied to compare the ReHo results between pre-and post-operation CSM patients and healthy volunteers. A second-level paired 2-tailed Student's t test was applied to compare the ReHo results between pre-and post-operation CSM patients. Pearson correlation analysis was performed to assess the correlations between the altered ReHo and clinical evaluation. Results Compared with healthy volunteers, pre-operation patients showed significantly lower ReHo in the left postcentral gyrus/precentral gyrus, together with enhanced ReHo in the right superior parietal lobule (GRF correction, P<0.05). Post-operation CSM patients showed significantly lower ReHo in the right superior parietal lobule comparing with healthy volunteers, as well as enhanced ReHo in the left postcentral gyrus/precentral gyrus comparing with pre-operation (GRF correction, P<0.05). Abnormal ReHo areas in CSM patients demonstrated no significant correlation with clinical measurements (P>0.05) between pre-operation and post-operation. Conclusions Myelopathy in cervical cord may affect intrinsic cerebral activity, as patients with CSM show disrupted regional homogeneity within sensorimotor network. The change of ReHo following decompression suggests that central plasticity may influence functional recovery.