MRI evidence of brain atrophy, white matter damage, and functional adaptive changes in patients with cervical spondylosis and prolonged spinal cord compression

Bernabéu-Sanz, Ángela; López-Celada, Susana; López, Pedro Moreno; Fernández-Jover, Eduardo

doi:10.1007/s00330-019-06352-z

Cited by 43 publications

(42 citation statements)

References 44 publications

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“…Whereas remote degeneration in DCM patients compared to HC corroborates previous reports[13,14,38,40,41], tractbased approaches also delineated gradual changes between NMDC and symptomatic DCM patients. Alterations above the compression level further endorse brain studies[42][43][44] that reported changes in motor and somatosensory cortex in symptomatic DCM patients with degenerative CSC compression. A decrease of CSA at the C3 level in DCM compared to HC corresponds with previous studies[10,13,14,40] and further points to remote degeneration rostrally to MCL.…”

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confidence: 55%

Diffusion magnetic resonance imaging reveals tract‐specific microstructural correlates of electrophysiological impairments in non‐myelopathic and myelopathic spinal cord compression

Valošek

Labounek

Horák

et al. 2021

Euro J of Neurology

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Background and purpose Non‐myelopathic degenerative cervical spinal cord compression (NMDC) frequently occurs throughout aging and may progress to potentially irreversible degenerative cervical myelopathy (DCM). Whereas standard clinical magnetic resonance imaging (MRI) and electrophysiological measures assess compression severity and neurological dysfunction, respectively, underlying microstructural deficits still have to be established in NMDC and DCM patients. The study aims to establish tract‐specific diffusion MRI markers of electrophysiological deficits to predict the progression of asymptomatic NMDC to symptomatic DCM. Methods High‐resolution 3 T diffusion MRI was acquired for 103 NMDC and 21 DCM patients compared to 60 healthy controls to reveal diffusion alterations and relationships between tract‐specific diffusion metrics and corresponding electrophysiological measures and compression severity. Relationship between the degree of DCM disability, assessed by the modified Japanese Orthopaedic Association scale, and tract‐specific microstructural changes in DCM patients was also explored. Results The study identified diffusion‐derived abnormalities in the gray matter, dorsal and lateral tracts congruent with trans‐synaptic degeneration and demyelination in chronic degenerative spinal cord compression with more profound alterations in DCM than NMDC. Diffusion metrics were affected in the C3‐6 area as well as above the compression level at C3 with more profound rostral deficits in DCM than NMDC. Alterations in lateral motor and dorsal sensory tracts correlated with motor and sensory evoked potentials, respectively, whereas electromyography outcomes corresponded with gray matter microstructure. DCM disability corresponded with microstructure alteration in lateral columns. Conclusions Outcomes imply the necessity of high‐resolution tract‐specific diffusion MRI for monitoring degenerative spinal pathology in longitudinal studies.

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confidence: 55%

Diffusion magnetic resonance imaging reveals tract‐specific microstructural correlates of electrophysiological impairments in non‐myelopathic and myelopathic spinal cord compression

Valošek

Labounek

Horák

et al. 2021

Euro J of Neurology

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“…For the C2 level, the DTI metrics were significantly correlated with the mJOA at different stages: before surgery and at 3-and 6-month follow-up. This is not surprising because it has been proved that compression might affect the distal spinal cord, even in the noncompressed regions, [24][25][26][27][28] which may represent Wallerian degeneration that has spread from a more caudal area of stenosis. 29 Additionally, our results show that preoperative FA for the C2 level was correlated with the postoperative mJOA recovery rate.…”

Section: Discussionmentioning

confidence: 99%

The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI

Han

et al. 2020

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: DTI has been proved valuable for the diagnosis of degenerative cervical myelopathy, whereas its capacity for predicting the outcome of surgery is still under debate. Here we conduct a prospective cohort study to analyze the capacity of DTI for evaluating and predicting laminoplasty surgery outcome for degenerative cervical myelopathy. MATERIALS AND METHODS: We recruited 55 patients with degenerative cervical myelopathy who underwent DTI before surgery and at 3-and 6-month follow-up stages, and 20 healthy subjects. For clinical assessment, the modified Japanese Orthopedic Association scale was recorded for each patient at different stages. DTI metrics were compared between patients before surgery and healthy subjects. Spearman correlation and receiver operating characteristic were used to analyze the evaluation and prediction capacity of DTI for the modified Japanese Orthopedic Association scale, respectively. We analyzed different vertebral levels: maximal compression level, average of all compression levels, and C2 level. RESULTS: DTI metrics were significantly different between patients before surgery and healthy subjects. Before surgery, DTI for the maximal compression level or DTI for the average of all compression levels had no significant correlation with the modified Japanese Orthopedic Association scale. For all stages, DTI at the C2 level was correlated with the modified Japanese Orthopedic Association scale. DTI metrics at the C2 level before surgery were significantly correlated with the postoperative modified Japanese Orthopedic Association scale recovery rate. Receiver operating characteristic analysis demonstrated that fractional anisotropy at C2 was capable of predicting the postoperative modified Japanese Orthopedic Association scale recovery rate (P ¼ .04). CONCLUSIONS: The DTI metrics before laminoplasty surgery, especially fractional anisotropy at the C2 level, have the potential for evaluating and predicting the degenerative cervical myelopathy surgery outcome. ABBREVIATIONS: AC ¼ all compression; AD ¼ axial diffusivity; DCM ¼ degenerative cervical myelopathy; FA ¼ fractional anisotropy; MC ¼ maximal compression; MD ¼ mean diffusivity; mJOA ¼ modified Japanese Orthopedic Association scale; RD ¼ radial diffusivity; ROC ¼ receiver operating characteristic

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“…When investigating volumetric differences within patients, we found male patients exhibited larger GMV in various regions compared to female patients, including motor, language, and pain related cortices. Previous studies have revealed DCM patients exhibit functional and morphological alterations within primary motor and sensorimotor cortices when compared to age-matched HCs [11,35,36]. We suspect patients experience alterations in such brain regions due to hormonal, neuroinflammatory, and neuronal compensatory differences between sexes [23].…”

Section: Sex-dependent Cortical Volumetric Differences In Patientsmentioning

confidence: 78%

Sex-Dependent Cortical Volume Changes in Patients with Degenerative Cervical Myelopathy

Oughourlian

Wang

Salamon

et al. 2021

JCM

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Degenerative cervical myelopathy (DCM) is a progressive condition characterized by degeneration of osseocartilaginous structures within the cervical spine resulting in compression of the spinal cord and presentation of clinical symptoms. Compared to healthy controls (HCs), studies have shown DCM patients experience structural and functional reorganization in the brain; however, sex-dependent cortical differences in DCM patients remains largely unexplored. In the present study, we investigate the role of sex differences on the structure of the cerebral cortex in DCM and determine how structural differences may relate to clinical measures of neurological function. T1-weighted structural MRI scans were acquired in 85 symptomatic and asymptomatic patients with DCM and 90 age-matched HCs. Modified Japanese Orthopedic Association (mJOA) scores were obtained for patients. A general linear model was used to determine vertex-level significant differences in gray matter volume (GMV) between the following groups (1) male HCs and female HCs, (2) male patients and female patients, (3) male patients and male HCs, and (4) female patients and female HCs. Within patients, males exhibited larger GMV in motor, language, and vision related brain regions compared to female DCM patients. Males demonstrated a significant positive correlation between GMV and mJOA score, in which patients with worsening neurological symptoms exhibited decreasing GMV primarily across somatosensory and motor related cortical regions. Females exhibited a similar association, albeit across a broader range of cortical areas including those involved in pain processing. In sensorimotor regions, female patients consistently showed smaller GMV compared with male patients, independent of mJOA score. Results from the current study suggest strong sex-related differences in cortical volume in patients with DCM, which may reflect hormonal influence or differing compensation mechanisms.

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MRI evidence of brain atrophy, white matter damage, and functional adaptive changes in patients with cervical spondylosis and prolonged spinal cord compression

Cited by 43 publications

References 44 publications

Diffusion magnetic resonance imaging reveals tract‐specific microstructural correlates of electrophysiological impairments in non‐myelopathic and myelopathic spinal cord compression

Diffusion magnetic resonance imaging reveals tract‐specific microstructural correlates of electrophysiological impairments in non‐myelopathic and myelopathic spinal cord compression

The Evaluation and Prediction of Laminoplasty Surgery Outcome in Patients with Degenerative Cervical Myelopathy Using Diffusion Tensor MRI

Sex-Dependent Cortical Volume Changes in Patients with Degenerative Cervical Myelopathy

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