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Voxel-based analysis of grey and white matter degeneration in cervical spondylotic myelopathy.

Grabher P, Mohammadi S, Trachsler A, Friedl S, David G, Sutter R, Weiskopf N, Thompson AJ, Curt A, Freund P - Sci Rep (2016)

Bottom Line: Fractional anisotropy (FA) was reduced in the PC (-11.98%, p = 0.006) and lateral CST (-12.96%, p = 0.014).In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC.Light-touch score was associated with atrophy (R(2) = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020).

View Article: PubMed Central - PubMed

Affiliation: Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

ABSTRACT
In this prospective study, we made an unbiased voxel-based analysis to investigate above-stenosis spinal degeneration and its relation to impairment in patients with cervical spondylotic myelopathy (CSM). Twenty patients and 18 controls were assessed with high-resolution MRI protocols above the level of stenosis. Cross-sectional areas of grey matter (GM), white matter (WM), and posterior columns (PC) were measured to determine atrophy. Diffusion indices assessed tract-specific integrity of PC and lateral corticospinal tracts (CST). Regression analysis was used to reveal relationships between MRI measures and clinical impairment. Patients showed mainly sensory impairment. Atrophy was prominent within the cervical WM (13.9%, p = 0.004), GM (7.2%, p = 0.043), and PC (16.1%, p = 0.005). Fractional anisotropy (FA) was reduced in the PC (-11.98%, p = 0.006) and lateral CST (-12.96%, p = 0.014). In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC. Light-touch score was associated with atrophy (R(2) = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020). This study demonstrates voxel-based degeneration far above the stenosis at a level not directly affected by the compression and provides unbiased readouts of tract-specific changes that relate to impairment.

No MeSH data available.


Related in: MedlinePlus

Morphometric changes in cervical spinal cord above compression site at C2/C3.(A) Schematic illustration of segmented cross-sectional cervical areas of grey matter, white matter, and posterior columns remote to compression. Significant reductions are shown for cross-sectional cervical cord area of grey matter (B), white matter (C), and posterior columns (D) in patients compared to controls. (E) Correlation between ISNCSCI upper extremity light-touch (UELT) score and cross-sectional area of the posterior columns (for illustrative purposes, not adjusted for age).
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f1: Morphometric changes in cervical spinal cord above compression site at C2/C3.(A) Schematic illustration of segmented cross-sectional cervical areas of grey matter, white matter, and posterior columns remote to compression. Significant reductions are shown for cross-sectional cervical cord area of grey matter (B), white matter (C), and posterior columns (D) in patients compared to controls. (E) Correlation between ISNCSCI upper extremity light-touch (UELT) score and cross-sectional area of the posterior columns (for illustrative purposes, not adjusted for age).

Mentions: Volumetric as well as microstructural changes were observed in patients compared to controls above the level of stenosis at C2/C3. In patients, the cross-sectional cervical cord area was reduced by 12.8% (patients: 80.88 mm2, CI 75.59–86.17 mm2 vs. controls: 92.77 mm2, CI 88.88–96.67 mm2, p = 0.0032), GM area by 7.2% (patients: 17.80 mm2, CI 16.96–18.64 mm2 vs. controls: 19.18 mm2, CI 18.33–20.03 mm2, p = 0.0429), WM area by 13.9% (patients: 63.08 mm2, CI 58.42–67.75 mm2 vs. controls: 73.23 mm2, CI 69.88–76.57 mm2, p = 0.0041) and PC area by 16.1% (patients: 18.86 mm2, CI 17.30–20.41 mm2 vs. controls: 22.49 mm2, CI 21.06–23.92 mm2, p = 0.0051) (Fig. 1).


Voxel-based analysis of grey and white matter degeneration in cervical spondylotic myelopathy.

Grabher P, Mohammadi S, Trachsler A, Friedl S, David G, Sutter R, Weiskopf N, Thompson AJ, Curt A, Freund P - Sci Rep (2016)

Morphometric changes in cervical spinal cord above compression site at C2/C3.(A) Schematic illustration of segmented cross-sectional cervical areas of grey matter, white matter, and posterior columns remote to compression. Significant reductions are shown for cross-sectional cervical cord area of grey matter (B), white matter (C), and posterior columns (D) in patients compared to controls. (E) Correlation between ISNCSCI upper extremity light-touch (UELT) score and cross-sectional area of the posterior columns (for illustrative purposes, not adjusted for age).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4837346&req=5

f1: Morphometric changes in cervical spinal cord above compression site at C2/C3.(A) Schematic illustration of segmented cross-sectional cervical areas of grey matter, white matter, and posterior columns remote to compression. Significant reductions are shown for cross-sectional cervical cord area of grey matter (B), white matter (C), and posterior columns (D) in patients compared to controls. (E) Correlation between ISNCSCI upper extremity light-touch (UELT) score and cross-sectional area of the posterior columns (for illustrative purposes, not adjusted for age).
Mentions: Volumetric as well as microstructural changes were observed in patients compared to controls above the level of stenosis at C2/C3. In patients, the cross-sectional cervical cord area was reduced by 12.8% (patients: 80.88 mm2, CI 75.59–86.17 mm2 vs. controls: 92.77 mm2, CI 88.88–96.67 mm2, p = 0.0032), GM area by 7.2% (patients: 17.80 mm2, CI 16.96–18.64 mm2 vs. controls: 19.18 mm2, CI 18.33–20.03 mm2, p = 0.0429), WM area by 13.9% (patients: 63.08 mm2, CI 58.42–67.75 mm2 vs. controls: 73.23 mm2, CI 69.88–76.57 mm2, p = 0.0041) and PC area by 16.1% (patients: 18.86 mm2, CI 17.30–20.41 mm2 vs. controls: 22.49 mm2, CI 21.06–23.92 mm2, p = 0.0051) (Fig. 1).

Bottom Line: Fractional anisotropy (FA) was reduced in the PC (-11.98%, p = 0.006) and lateral CST (-12.96%, p = 0.014).In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC.Light-touch score was associated with atrophy (R(2) = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020).

View Article: PubMed Central - PubMed

Affiliation: Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland.

ABSTRACT
In this prospective study, we made an unbiased voxel-based analysis to investigate above-stenosis spinal degeneration and its relation to impairment in patients with cervical spondylotic myelopathy (CSM). Twenty patients and 18 controls were assessed with high-resolution MRI protocols above the level of stenosis. Cross-sectional areas of grey matter (GM), white matter (WM), and posterior columns (PC) were measured to determine atrophy. Diffusion indices assessed tract-specific integrity of PC and lateral corticospinal tracts (CST). Regression analysis was used to reveal relationships between MRI measures and clinical impairment. Patients showed mainly sensory impairment. Atrophy was prominent within the cervical WM (13.9%, p = 0.004), GM (7.2%, p = 0.043), and PC (16.1%, p = 0.005). Fractional anisotropy (FA) was reduced in the PC (-11.98%, p = 0.006) and lateral CST (-12.96%, p = 0.014). In addition, radial (+28.47%, p = 0.014), axial (+14.72%, p = 0.005), and mean (+16.50%, p = 0.001) diffusivities were increased in the PC. Light-touch score was associated with atrophy (R(2) = 0.3559, p = 0.020) and FA (z score 3.74, p = 0.003) in the PC, as was functional independence and FA in the lateral CST (z score 3.68, p = 0.020). This study demonstrates voxel-based degeneration far above the stenosis at a level not directly affected by the compression and provides unbiased readouts of tract-specific changes that relate to impairment.

No MeSH data available.


Related in: MedlinePlus