Brainstem and subcortical regions volume loss in patients with degenerative cervical myelopathy and its association with spinal cord compression severity

Filimonova, Elena; Vasilenko, Ivan; Kubetsky, Yulij; Prokhorov, Oleg; Abdaev, Mars; Rzaev, Jamil

doi:10.1016/j.clineuro.2023.107943

Cited by 4 publications

(4 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Focal damage to the spinal cord also remotely perturbs tissue integrity of ascending and descending tracts [4,41]. Our observations of neurodegenerative changes (decreased R1 as an indirect measure of myelin changes) in the PAG of DCM patients support the hypothesis of ongoing demyelination within the brainstem [6] extending the loss of tissue integrity from the cervical cord towards the brain. Reduced fibre density within tracts passing through the brainstem to sensorimotor areas has been identified in DCM patients [42].…”

Section: Ta B L Esupporting

confidence: 78%

“…These severe cases can result in long-lasting impairments of upper extremity function, gait difficulties, and bladder dysfunction [2]. DCM is characterized by chronic spinal cord compression, leading to neural tissue destruction at the site of compression, but also remote changes of the spinal cord [3,4], and can even affect the brain [5,6]. The current standard of care for moderate to severe DCM is surgical decompression.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Quantifying neurodegeneration of the cervical cord and brain in degenerative cervical myelopathy: A multicentre study using quantitative magnetic resonance imaging

Freund,

Boller,

Emmenegger

et al. 2024

Euro J of Neurology

View full text Add to dashboard Cite

Background and purposeSimultaneous assessment of neurodegeneration in both the cervical cord and brain across multiple centres can enhance the effectiveness of clinical trials. Thus, this study aims to simultaneously assess microstructural changes in the cervical cord and brain above the stenosis in degenerative cervical myelopathy (DCM) using quantitative magnetic resonance imaging (MRI) in a multicentre study.MethodsWe applied voxelwise analysis with a probabilistic brain/spinal cord template embedded in statistical parametric mappin (SPM‐BSC) to process multi parametric mapping (MPM) including effective transverse relaxation rate (R2*), longitudinal relaxation rate (R1), and magnetization transfer (MT), which are indirectly sensitive to iron and myelin content. Regression analysis was conducted to establish associations between neurodegeneration and clinical impairment. Thirty‐eight DCM patients (mean age ± SD = 58.45 ± 11.47 years) and 38 healthy controls (mean age ± SD = 41.18 ± 12.75 years) were recruited at University Hospital Balgrist, Switzerland and Toronto Western Hospital, Canada.ResultsRemote atrophy was observed in the cervical cord (p = 0.002) and in the left thalamus (0.026) of the DCM group. R1 was decreased in the periaqueductal grey matter (p = 0.014), thalamus (p = 0.001), corpus callosum (p = 0.0001), and cranial corticospinal tract (p = 0.03). R2* was increased in the primary somatosensory cortices (p = 0.008). Sensory impairments were associated with increased iron‐sensitive R2* in the thalamus and periaqueductal grey matter in DCM.ConclusionsSimultaneous assessment of the spinal cord and brain revealed DCM‐induced demyelination, iron deposition, and atrophy. The extent of remote neurodegeneration was associated with sensory impairment, highlighting the intricate and expansive nature of microstructural neurodegeneration in DCM, reaching beyond the stenosis level.

show abstract

Section: Ta B L Esupporting

confidence: 78%

Section: Introductionmentioning

confidence: 99%

Quantifying neurodegeneration of the cervical cord and brain in degenerative cervical myelopathy: A multicentre study using quantitative magnetic resonance imaging

Freund,

Boller,

Emmenegger

et al. 2024

Euro J of Neurology

View full text Add to dashboard Cite

show abstract

“…Computing MSCC with other shape metrics will likely increase the ability to detect and characterise various types of compressions 37 . Some studies directly used the AP diameter or CSA in their analysis without self-normalization with healthy levels above and below the compression sites 4,16,32,33,38 . Spinal cord morphometry has a large inter-subject variability, especially for CSA, AP and RL diameters 10,11,14 and between males and females 11,14,15,[39][40][41] .…”

Section: Comparison Of Manual Vs Automatic Mri Measuresmentioning

confidence: 99%

“…Only a few studies have used automatic or semi-automatic measures to compute spinal cord morphometrics 5,16,17,[31][32][33] . The majority of the studies measured the AP diameter on the midsagittal slice 1,12,29,[34][35][36] .…”

Section: Comparison Of Manual Vs Automatic Mri Measuresmentioning

confidence: 99%

Normalizing Spinal Cord Compression Morphometric Measures: Application in Degenerative Cervical Myelopathy

Bédard,

Valošek,

Seif

et al. 2024

Preprint

View full text Add to dashboard Cite

Objective: Automatic and robust characterization of spinal cord shape from MRI images is relevant to assess the severity of spinal cord compression in degenerative cervical myelopathy (DCM) and to guide therapeutic strategy. Despite its popularity, the maximum spinal cord compression (MSCC) index has practical limitations to objectively assess the severity of cord compression. Firstly, it is computed by normalizing the anteroposterior cord diameter by that above and below the level of compression, but it does not account for the fact that the spinal cord itself varies in size along the superior-inferior axis, making this MSCC sensitive to the level of compression. Secondly, spinal cord shape varies across individuals, making MSCC also sensitive to the size and shape of every individual. Thirdly, MSCC is typically computed by the expert-rater on a single sagittal slice, which is time-consuming and prone to inter-rater variability. In this study, we propose a fully automatic pipeline to compute MSCC. Methods: We extended the traditional MSCC (based on the anteroposterior diameter) to other shape metrics (transverse diameter, area, eccentricity, and solidity), and proposed a normalization strategy using a database of healthy adults (n=203) to address the variability of the spinal cord anatomy between individuals. We validated the proposed method in a cohort of DCM patients (n=120) with manually derived morphometric measures and predicted the therapeutic decision (operative/conservative) using a stepwise binary logistic regression including demographics, clinical scores, and electrophysiological assessment. Results: The automatic and normalized MSCC measures significantly correlated with clinical scores and predicted the therapeutic decision with higher accuracy than the manual MSCC. Results show that the sensory dysfunction of the upper extremities (mJOA subscore), the presence of myelopathy and the proposed MRI-based normalized morphometric measures were significant predictors of the therapeutic decision. The model yielded an area under the curve of the receiver operating characteristic of 80%. Conclusion: The study introduced an automatic method for computation of normalized MSCC measures of cord compression from MRI scans, which is an important step towards better informed therapeutic decisions in DCM patients. The method is open-source and available in the Spinal Cord Toolbox v6.0.

show abstract

Brain MRI changes in degenerative cervical myelopathy: a systematic review

Rafati Fard,

Mowforth,

Yuan

et al. 2024

eBioMedicine

View full text Add to dashboard Cite

Brainstem and subcortical regions volume loss in patients with degenerative cervical myelopathy and its association with spinal cord compression severity

Cited by 4 publications

References 32 publications

Quantifying neurodegeneration of the cervical cord and brain in degenerative cervical myelopathy: A multicentre study using quantitative magnetic resonance imaging

Quantifying neurodegeneration of the cervical cord and brain in degenerative cervical myelopathy: A multicentre study using quantitative magnetic resonance imaging

Normalizing Spinal Cord Compression Morphometric Measures: Application in Degenerative Cervical Myelopathy

Brain MRI changes in degenerative cervical myelopathy: a systematic review

Contact Info

Product

Resources

About