Abstract:Highlights
Degenerative cervical myelopathy is the most common cause of chronic impairment of the spinal cord.
MRI-based anatomical assessment of cerebral and cerebellar areas revealed significant tissue volume reduction in DCM patients compared to healthy controls.
Disease severity correlated with cerebral and cerebellar atrophy in the primary motor cortex, primary somatosensory cortex and cerebellar areas.
Chronic injury to the spinal … Show more
“…Our current findings are consistent with previous findings that patients with DCM exhibited gray matter atrophy within the sensorimotor cortex ( 47 , 48 , 53 ). Studies have shown that DCM patients exhibited decreased gray matter density within the primary motor cortex (M1), primary sensory cortex (S1), and supplementary motor area (SMA) ( 54 ). Moreover, several studies have also reported decreased regional functional activity and metabolic demand within these regions, indicating that the altered brain function in DCM patients could result from structural changes in the sensorimotor cortices ( 16 , 20 , 23 ).…”
BackgroundPrevious studies have shown the whole-brain global functional connectivity density (gFCD) and gray matter volume (GMV) alterations in patients with degenerative cervical myelopathy (DCM). However, no study aimed to investigate the associations between the spatial patterns of GMV and gFCD alterations in patients with DCM.MethodsStructural data and resting-state functional MRI data of 35 DCM patients and 35 matched healthy controls were collected to assess their gFCD and GMV and investigate gFCD and GMV alterations in patients with DCM and their spatial pattern associations.ResultsIn our current study, significant gFCD and GMV differences were observed in some regions of the visual system, sensorimotor cortices, and cerebellum between patients with DCM and healthy controls. In our findings, decreased gFCD was found in areas primarily located at the sensorimotor cortices, while increased gFCD was observed primarily within areas located at the visual system and cerebellum. Decreased GMV was seen in the left thalamus, bilateral supplementary motor area (SMA), and left inferior occipital cortices in patients with DCM, while increased GMV was observed in the cerebellum.ConclusionOur findings suggest that structural and functional alterations independently contributed to the neuropathology of DCM. However, longitudinal studies are still needed to further illustrate the associations between structural deficits and functional alterations underlying the onset of brain abnormalities as DCM develops.
“…The acute phase is associated to Wallerian degeneration of ascending and descending tracts with gradual formation of cavities in the cord, and the formation of the glial scar decreases significantly the growth capabilities of axons across the injury [31][32][33]. The blockade of nerve conduction results in paralysis as well as temporary loss of neural functions by spinal shock [3,34,35]. The associated oxidative stress results in the reduction of glutamate transport in astrocytes, thereby stimulating excitotoxicity because of augmented extracellular glutamate [3,36].…”
Spinal cord injury (SCI) is a distressing incident with abrupt onset of the motor as well as sensory dysfunction, and most often, the injury occurs as result of high-energy or velocity accidents as well as contact sports and falls in the elderly. The key challenges associated with nerve repair are the lack of self-repair as well as neurotrophic factors and primary and secondary neuronal apoptosis, as well as factors that prevent the regeneration of axons locally. Neurons that survive the initial traumatic damage may be lost due to pathogenic activities like neuroinflammation and apoptosis. Implanted stem cells are capable of differentiating into neural cells that replace injured cells as well as offer local neurotrophic factors that aid neuroprotection, immunomodulation, axonal sprouting, axonal regeneration, and remyelination. At the microenvironment of SCI, stem cells are capable of producing growth factors like brain-derived neurotrophic factor and nerve growth factor which triggers neuronal survival as well as axonal regrowth. Although stem cells have proven to be of therapeutic value in SCI, the major disadvantage of some of the cell types is the risk for tumorigenicity due to the contamination of undifferentiated cells prior to transplantation. Local administration of stem cells via either direct cellular injection into the spinal cord parenchyma or intrathecal administration into the subarachnoid space is currently the best transplantation modality for stem cells during SCI.
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