Tracking white and grey matter degeneration along the spinal cord axis in degenerative cervical myelopathy
Tracking white and grey matter degeneration along the spinal cord axis in degenerative cervical myelopathy
Abstract ObjectiveTo determine tissue-specific neurodegeneration across the spinal cord in patients with mild-moderate degenerative cervical myelopathy (DCM). MethodsTwenty-four mild-moderate DCM and 24 healthy subjects were recruited. In patients, a T2-weighted scan was acquired at the compression site, while in all participants a T2*-weighted and diffusion-weighted scan was acquired at the cervical level (C2-C3) and in the lumbar enlargement (i.e. rostral and caudal to the site of compression). We quantified intramedullary signal changes, maximal canal and cord compression, white (WM) and grey matter (GM) atrophy, and microstructural indices from diffusion-weighted scans. All patients underwent clinical (modified Japanese Orthopaedic Association (mJOA)) and electrophysiological assessments. Regression analysis assessed associations between MRI readouts and electrophysiological and clinical outcomes. ResultsTwenty patients were classified with mild and four with moderate DCM using the mJOA scale. The most frequent site of compression was at C5-C6 level with maximum cord compression of 4.68±0.83 mm. Ten patients showed imaging evidence of cervical myelopathy. In the cervical cord, WM and GM atrophy and WM microstructural changes were evident, while in the lumbar cord only WM showed atrophy and microstructural changes. Remote cervical cord WM microstructural changes were pronounced in patients with radiological myelopathy and associated with impaired electrophysiology. Lumbar cord WM atrophy was associated with lower limb sensory impairments. ConclusionTissue-specific neurodegeneration revealed by quantitative MRI, already apparent across the spinal cord in mild-moderate DCM prior to the onset of severe clinical impairments. WM microstructural changes are particularly sensitive to remote pathologically and clinically eloquent changes in DCM.
Fehlings Michael、Samson Rebecca S.、David Gergely、Curt Armin、Seif Maryam、Pfender Nikolai、Hupp Markus、Vallotton Kevin、Wheeler-Kingshott Claudia A. M. Gandini、Cohen-Adad Julien、Freund Patrick
University of Toronto Spine Program and Toronto Western HospitalNMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain SciencesSpinal Cord Injury Center Balgrist, University of ZurichSpinal Cord Injury Center Balgrist, University of ZurichSpinal Cord Injury Center Balgrist, University of Zurich||Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain SciencesSpinal Cord Injury Center Balgrist, University of ZurichSpinal Cord Injury Center Balgrist, University of ZurichSpinal Cord Injury Center Balgrist, University of ZurichNMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences||Department of Brain and Behavioural Sciences, University of Pavia||Brain Connectivity Centre, IRCCS Mondino FoundationNeuroPoly Lab, Institute of Biomedical Engineering||Functional Neuroimaging Unit, CRIUGM, University of Montreal||Mila - Quebec AI InstituteSpinal Cord Injury Center Balgrist, University of Zurich||Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences||Department of Brain Repair and Rehabilitation, UCL Institute of Neurology||Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology
神经病学、精神病学医学研究方法基础医学
Fehlings Michael,Samson Rebecca S.,David Gergely,Curt Armin,Seif Maryam,Pfender Nikolai,Hupp Markus,Vallotton Kevin,Wheeler-Kingshott Claudia A. M. Gandini,Cohen-Adad Julien,Freund Patrick.Tracking white and grey matter degeneration along the spinal cord axis in degenerative cervical myelopathy[EB/OL].(2025-03-28)[2025-05-29].https://www.medrxiv.org/content/10.1101/2021.04.18.21255238.点此复制
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