Beyond the aging spine – a systematic review of functional changes in the human brain in cervical spondylotic myelopathy

Khan, Ali Fahim; Muhammad, Fauziyya; Mohammadi, Esmaeil; O’Neal, Christen; Haynes, Grace; Hameed, Sanaa; Walker, Brynden; Rohan, Michael L.; Yabluchanskiy, Andriy; Smith, Zachary Adam

doi:10.1007/s11357-023-00954-8

Cited by 4 publications

(5 citation statements)

References 69 publications

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“…However, the article by Khan and co-authors on the same topic gives great hope that the implementation of fMRI may facilitate the diagnosis of CSM. This study highlights even small changes in the brain, especially those responsible for motor control [ 38 ]. It is worth adding that the research of Chang and co-authors gives great hope that neuroimaging may contribute to significant development in the diagnosis of CSM [ 39 ].…”

Section: Future Directionsmentioning

confidence: 87%

“…Nevertheless, it is worth noting that fMRI may be one of the elements facilitating the diagnosis of CSM due to the quantitative examination of changes in the brain. The field is still in the development stage [ 38 ]. The research conducted by Chang et al involved an analysis that included patients with CSM and healthy people who underwent fMRI and structural MRI.…”

Section: Discussionmentioning

confidence: 99%

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Cervical Spondylotic Myelopathy—Diagnostics and Clinimetrics

Opara,

Odzimek

2024

Diagnostics

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Cervical myelopathy is referred to in many ways in the English literature, for example, as cervical spondylotic myelopathy (CSM), spondylotic radiculomyelopathy (SRM) or degenerative cervical myelopathy (DCM). In addition, more frequent occurrences are noted in older adults and to a greater extent in men. The causes of the effects of cervical myelopathy may be the appearance of lesions on the spinal cord, ischemia due to compression of the vertebral artery and repeated micro-injuries during maximal movements—hyperflexion or hyperextension. It is well known that lesions on the spinal cord may occur in a quarter of the population, and this problem is clearly noted in people over 60 years old. The symptoms of SCM develop insidiously, and their severity and side (unilateral or bilateral) are associated with the location and extent of spinal cord compression. Neurological examination most often diagnoses problems in the upper limbs (most often paresis with developing hand muscle atrophy), pyramidal paralysis in one or both lower limbs and disorders in the urinary system. To make a diagnosis of CSM, it is necessary to perform MRI and neurophysiological tests (such as EMG or sensory and/or motor-evoked potentials). The use of appropriately selected scales and specific tests in diagnostics is also crucial. This narrative review article describes the latest knowledge on the diagnosis and clinimetrics of cervical spondylotic myelopathy in adults and provides future directions.

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Section: Future Directionsmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Cervical Spondylotic Myelopathy—Diagnostics and Clinimetrics

Opara,

Odzimek

2024

Diagnostics

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“…Cord compression following degenerative processes in cervical spine often leads to Degenerative Cervical Myelopathy (DCM) also known as cervical spondylotic myelopathy, a common cause of myelopathy in adults. It is associated with cervical spinal cord tissue injury [ 1 ] and functional changes in the brain [ 2 ]. DCM commonly presents with neurologic manifestations such as loss of dexterity and gait issues [ 3 ] and patients are typically screen using Magnetic Resonance Imaging [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Systematic review protocol for complications following surgical decompression of degenerative cervical myelopathy

Mohammadi,

Khan,

Villeneuve

et al. 2024

PLoS ONE

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Background Degenerative Cervical Myelopathy (DCM) is one of the most common degenerative disorders of cervical spine and sources of cord dysfunction in adults. It usually manifests with neurologic presentations such as loss of dexterity and gait issues. Treatment for moderate and severe cases of DCM is surgical decompression of the region. There are many approaches available for surgical intervention which could be categorized into anterior and posterior based on the side of neck where operation takes place. Additionally, for certain cases the hybridized anterior-posterior combined surgery is indicated. While there are many technical differences between these approaches with each having its own advantages, the complications and safety profiles of them are not fully disclosed. This protocol aims to systematically search for current reports on complications of surgical decompression methods of DCM and pool them for robust evidence generation. Method Search will be carried out in PubMed, Scopus, and Cochrane databases for retrospective and prospective surgical series, cohorts, or trials being performed for DCM with at least a sample size of 20 patients. Query strings will be designed to capture reports with details of complications with no year limit. Studies not being original (e.g., review articles, case reports, etc.), not in English, having patients younger than 18-years-old, and not reporting at least one complication will be excluded. Two independent reviewers will review the titles and abstracts for first round of screening. Full text of retrieved studies from previous round will be screened again by the same reviewers. In case of discrepancy, the third senior reviewer will be consulted. Eligible studies will then be examined for data extraction where data will be recorded into standardized form. Cumulative incidence and 95% confidence intervals of complication will be then pooled based on generalized linear mixed models with consideration of approach of surgery as subgroups. Heterogeneity tests will be performed for assessment of risk of bias. Discussion This systematic review is aimed at providing practical information for spine surgeons on the rates of complications of different surgical approaches of DCM decompression. Proper decision-making regarding the surgical approach in addition to informing patients could be facilitated through results of this investigation.

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“…Resting-state functional magnetic resonance imaging (rs-fMRI) is an effective tool for exploring the neural mechanisms of various diseases (Khan et al, 2024 ). It examines the spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signal (Biswal et al, 1997 ).…”

Section: Introductionmentioning

confidence: 99%

“…Recently, it has become increasingly popular in addressing discrepancies in clinical research and has been employed to investigate the persistent brain alterations in a variety of disease such as anxiety disorder, major depression and autism spectrum disorder (Serra-Blasco et al, 2021 ; Wang et al, 2022 ), but there is no systematic meta-analysis of neuroimaging studies related to cervical spondylosis. Although three systematic reviews on CS, which have been published recently, have provided an overview of CS-related neuroimaging studies from a macroscopic perspective, they did not examine the most consistent and core brain alterations in CS patients (Wu and Wang, 2023 ; Fard et al, 2024 ; Khan et al, 2024 ). However, the identification of the consistent and core brain alterations may help us understand its underlying neuropathological basis, further explain the symptoms of CS patients, and facilitate the diagnosis and treatment of the disease (Tahmasian et al, 2019 ).…”

Section: Introductionmentioning

confidence: 99%

Abnormalities of brain structure and function in cervical spondylosis: a multi-modal voxel-based meta-analysis

Cheng,

Zhang,

et al. 2024

Front. Neurosci.

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BackgroundPrevious neuroimaging studies have revealed structural and functional brain abnormalities in patients with cervical spondylosis (CS). However, the results are divergent and inconsistent. Therefore, the present study conducted a multi-modal meta-analysis to investigate the consistent structural and functional brain alterations in CS patients.MethodsA comprehensive literature search was conducted in five databases to retrieve relevant resting-state functional magnetic resonance imaging (rs-fMRI), structural MRI and diffusion tensor imaging (DTI) studies that measured brain functional and structural differences between CS patients and healthy controls (HCs). Separate and multimodal meta-analyses were implemented, respectively, by employing Anisotropic Effect-size Signed Differential Mapping software.Results13 rs-fMRI studies that used regional homogeneity, amplitude of low-frequency fluctuations (ALFF) and fractional ALFF, seven voxel-based morphometry (VBM) studies and one DTI study were finally included in the present research. However, no studies on surface-based morphometry (SBM) analysis were included in this research. Due to the insufficient number of SBM and DTI studies, only rs-fMRI and VBM meta-analyses were conducted. The results of rs-fMRI meta-analysis showed that compared to HCs, CS patients demonstrated decreased regional spontaneous brain activities in the right lingual gyrus, right middle temporal gyrus (MTG), left inferior parietal gyrus and right postcentral gyrus (PoCG), while increased activities in the right medial superior frontal gyrus, bilateral middle frontal gyrus and right precuneus. VBM meta-analysis detected increased GMV in the right superior temporal gyrus (STG) and right paracentral lobule (PCL), while decreased GMV in the left supplementary motor area and left MTG in CS patients. The multi-modal meta-analysis revealed increased GMV together with decreased regional spontaneous brain activity in the left PoCG, right STG and PCL among CS patients.ConclusionThis meta-analysis revealed that compared to HCs, CS patients had significant alterations in GMV and regional spontaneous brain activity. The altered brain regions mainly included the primary visual cortex, the default mode network and the sensorimotor area, which may be associated with CS patients' symptoms of sensory deficits, blurred vision, cognitive impairment and motor dysfunction. The findings may contribute to understanding the underlying pathophysiology of brain dysfunction and provide references for early diagnosis and treatment of CS.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/, CRD42022370967.

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Beyond the aging spine – a systematic review of functional changes in the human brain in cervical spondylotic myelopathy

Cited by 4 publications

References 69 publications

Cervical Spondylotic Myelopathy—Diagnostics and Clinimetrics

Cervical Spondylotic Myelopathy—Diagnostics and Clinimetrics

Systematic review protocol for complications following surgical decompression of degenerative cervical myelopathy

Abnormalities of brain structure and function in cervical spondylosis: a multi-modal voxel-based meta-analysis

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