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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

Tract-specific changes in microstructure above stenosis in patients with CSM compared to healthy controls.(A) Sagittal FA template of all subjects showing the cervical spinal cord at C2/C3 level and axial slices overlaid with regions of interest (lateral corticospinal tracts (CST) in red, posterior columns (PC) in blue, and spinothalamic tracts in green) for labeling of the anatomical position of the findings. (B–F) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral CST and PC, respectively) revealing microstructural changes in patients compared to controls. In patients compared to controls, fractional anisotropy (FA) was reduced in the right lateral CST (B). In the PC, FA was reduced (C) and axial (D), radial (E), and mean diffusivity (F) increased. Colour bars indicate t-values. Axial slices are shown and their position is indicated by the z coordinate.
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f2: Tract-specific changes in microstructure above stenosis in patients with CSM compared to healthy controls.(A) Sagittal FA template of all subjects showing the cervical spinal cord at C2/C3 level and axial slices overlaid with regions of interest (lateral corticospinal tracts (CST) in red, posterior columns (PC) in blue, and spinothalamic tracts in green) for labeling of the anatomical position of the findings. (B–F) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral CST and PC, respectively) revealing microstructural changes in patients compared to controls. In patients compared to controls, fractional anisotropy (FA) was reduced in the right lateral CST (B). In the PC, FA was reduced (C) and axial (D), radial (E), and mean diffusivity (F) increased. Colour bars indicate t-values. Axial slices are shown and their position is indicated by the z coordinate.

Mentions: Voxel-based analysis of the cervical cord DTI revealed reductions in fractional anisotropy (FA) in the lateral CST (−12.96%, patients: 0.57, CI 0.53–0.61 vs. controls: 0.66, CI 0.63–0.68; x:4.5, y:−20.5, z:8.0, z score = 3.30, cluster extent = 144, p = 0.014, FWE corrected) and PC (−11.98%, patients: 0.59, CI 0.55–0.63 vs. controls: 0.67, CI 0.65–0.69; x:−2.0, y:−20.0, z:8.0, z score = 4.08, cluster extent = 174, p = 0.006, FWE corrected) while axial diffusivity (AD) (+14.72%, patients: 0.0019, CI 0.0019–0.0020 vs. controls: 0.0017, CI 0.0016–0.0017; x:−1.0, y:−18.5, z:41.0, z score = 3.91, cluster extent = 228, p = 0.005, FWE corrected), radial diffusivity (RD) (+28.47%, patients: 0.00073, CI 0.00064–0.00082 vs. controls: 0.00057, CI 0.00053-0.00060; x:1.0, y:−18.0, z:14.0, z score = 3.39, cluster extent = 203, p = 0.014, FWE corrected), and mean diffusivity (MD) (+16.50%, patients: 0.00073, CI 0.00064–0.00082 vs. controls: 0.00057, CI 0.00053–0.00060; x:2.0, y:−19.5, z:41.0, z score = 3.80, cluster extent = 379, p = 0.001, FWE corrected) were all increased in the PCs in patients when compared to controls (Figs 2 and 3).


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)

Tract-specific changes in microstructure above stenosis in patients with CSM compared to healthy controls.(A) Sagittal FA template of all subjects showing the cervical spinal cord at C2/C3 level and axial slices overlaid with regions of interest (lateral corticospinal tracts (CST) in red, posterior columns (PC) in blue, and spinothalamic tracts in green) for labeling of the anatomical position of the findings. (B–F) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral CST and PC, respectively) revealing microstructural changes in patients compared to controls. In patients compared to controls, fractional anisotropy (FA) was reduced in the right lateral CST (B). In the PC, FA was reduced (C) and axial (D), radial (E), and mean diffusivity (F) increased. Colour bars indicate t-values. Axial slices are shown and their position is indicated by the z coordinate.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f2: Tract-specific changes in microstructure above stenosis in patients with CSM compared to healthy controls.(A) Sagittal FA template of all subjects showing the cervical spinal cord at C2/C3 level and axial slices overlaid with regions of interest (lateral corticospinal tracts (CST) in red, posterior columns (PC) in blue, and spinothalamic tracts in green) for labeling of the anatomical position of the findings. (B–F) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral CST and PC, respectively) revealing microstructural changes in patients compared to controls. In patients compared to controls, fractional anisotropy (FA) was reduced in the right lateral CST (B). In the PC, FA was reduced (C) and axial (D), radial (E), and mean diffusivity (F) increased. Colour bars indicate t-values. Axial slices are shown and their position is indicated by the z coordinate.
Mentions: Voxel-based analysis of the cervical cord DTI revealed reductions in fractional anisotropy (FA) in the lateral CST (−12.96%, patients: 0.57, CI 0.53–0.61 vs. controls: 0.66, CI 0.63–0.68; x:4.5, y:−20.5, z:8.0, z score = 3.30, cluster extent = 144, p = 0.014, FWE corrected) and PC (−11.98%, patients: 0.59, CI 0.55–0.63 vs. controls: 0.67, CI 0.65–0.69; x:−2.0, y:−20.0, z:8.0, z score = 4.08, cluster extent = 174, p = 0.006, FWE corrected) while axial diffusivity (AD) (+14.72%, patients: 0.0019, CI 0.0019–0.0020 vs. controls: 0.0017, CI 0.0016–0.0017; x:−1.0, y:−18.5, z:41.0, z score = 3.91, cluster extent = 228, p = 0.005, FWE corrected), radial diffusivity (RD) (+28.47%, patients: 0.00073, CI 0.00064–0.00082 vs. controls: 0.00057, CI 0.00053-0.00060; x:1.0, y:−18.0, z:14.0, z score = 3.39, cluster extent = 203, p = 0.014, FWE corrected), and mean diffusivity (MD) (+16.50%, patients: 0.00073, CI 0.00064–0.00082 vs. controls: 0.00057, CI 0.00053–0.00060; x:2.0, y:−19.5, z:41.0, z score = 3.80, cluster extent = 379, p = 0.001, FWE corrected) were all increased in the PCs in patients when compared to controls (Figs 2 and 3).

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