Abstract: Background Motor dysfunction in children with spinal muscular atrophy（SMA）results from degeneration of anterior horn motor neurons. Prior research has demonstrated that spinal cord injury induces plastic changes in both brain structure and function. Based on this，it is hypothesized that children with SMA may also exhibit reorganization within brain networks. Understanding the functional features of the brain in children with SMA may offer additional data support for rehabilitation therapy. Objective To investigate resting-state brain network characteristics in children with SMA using functional near-infrared spectroscopy（fNIRS）. Methods Children aged 5 –10 years with SMA type 2 who were admitted to the Department of Rehabilitation Medicine of the Third Affiliated Hospital of Zhengzhou University from January to July 2024 were enrolled as the SMA group（n=23）. Age-matched healthy children who volunteered during the same period were recruited as controls（n=23）. fNIRS was used to record cerebral oxygenation signals from the bilateral frontal poles，dorsolateral prefrontal cortex（DLPFC），temporal lobes，Broca's area，and motor cortex during rest. Independent-samples t-tests were applied to compare group differences in functional connectivity matrices and graph-theoretical network metrics including global efficiency， local efficiency，nodal efficiency，nodal local efficiency，and clustering coefficient. Results The SMA group exhibited stronger functional connectivity than the control group（t=4.996，P<0.001），primarily located in the temporal lobe and DLPFC. Regarding global network metrics，no significant difference in global efficiency was found between the SMA and control groups（t=1.688，P>0.05）. However，local efficiency was significantly higher in the SMA group compared with controls（t=2.189， P=0.037）. For nodal metrics，the SMA group showed greater nodal efficiency in the primary motor cortex and supplementary motor area（t=2.266，P=0.031）. Additionally，both the clustering coefficient（t=2.177，P=0.038）and nodal local efficiency（t=2.187，P=0.037）were significantly higher in the frontopolar cortex compared with the control group. Conclusion Children with SMA exhibited enhanced functional connectivity within the resting-state brain network，and they may have a compensatory mechanism involving reorganization of multiple brain regions.

Key words: Spinal muscular atrophy, Functional near-infrared spectroscopy, Functional connectivity, Reorganization, Neuroplasticity

摘要： 背景 脊髓性肌萎缩症（SMA）患儿的运动功能障碍是由脊髓前角运动神经元的退化引起的，研究表明脊髓损伤后脑结构和脑功能均发生了可塑性改变，因此推测SMA患儿的脑网络也可能发生改变，了解SMA患儿大脑的功能特征可以为康复治疗提供更多的数据支持。目的 利用近红外脑功能成像（fNIRS）技术研究静息状态下SMA患儿脑功能网络的特点。方法 选取2024年1—7月入住郑州大学第三附属医院康复医学科进行康复治疗的5~10岁SMA 2型患儿为研究对象（SMA组，n=23），同期自愿参加本研究的5~10岁健康儿童为对照（对照组，n=23）。应用fNIRS技术对SMA组和对照组在静息状态时的双侧额极、背外侧前额叶、颞叶、Broca区及运动区的脑氧合信号进行记录。采用独立样本t检验比较两组儿童功能连接矩阵及全局效率、局部效率、节点效率、节点局部效率、聚类系数等网络度量。结果 SMA患儿大脑功能连接强于对照组（t=4.996，P<0.001），且主要位于颞叶及背外侧前额叶。在全局指标特性方面，SMA组和对照组的全局效率比较，差异无统计学意义（t=1.688，P>0.05）；SMA组的局部效率高于对照组（t=2.189，P=0.037）。节点指标特性方面，SMA组的节点效率在前运动区和辅助运动区大于对照组（t=2.266，P=0.031），聚类系数（t=2.177，P=0.038）及节点局部效率（t=2.187，P=0.037）在额极区大于对照组。结论 SMA患儿静息态脑网络功能连接增强，且SMA患儿可能存在涉及多个脑区重组的代偿机制。

关键词: 脊髓性肌萎缩症, 近红外脑功能成像, 功能性连接, 重组, 神经可塑性