Degenerative cervical myelopathy and alterations in functional cerebral connectivity

Brain MRI changes in degenerative cervical myelopathy: a systematic review

“…Whilst our explanation for the observed brain changes remains a hypothesis at this stage, it is supported by the broader literature, particularly the notion that spinal cord injury due to DCM can result in synaptic plasticity in an effort to preserve function. 66 Our hypothesis is further supported by the evidence base in SCI, where a meta-analysis of MRI brain activation in traumatic SCI similarly concluded that brain changes were likely a function of direct loss of function (comparable to our ‘pathological changes’ hypothesis) and adaptive cortical reorganization (comparable to our ‘compensatory changes’ hypothesis). 67 Moreover, a more recent voxel-based meta-analysis of structural MRI changes proposed that significant insular atrophy following SCI may in part contribute to the subsequent depression reported in patients, 68 providing additional support for our hypothesis that ‘pathological changes’ beyond the spinal cord occur and may help to explain the occurrence of symptoms in DCM.…”