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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

Associations between tract-specific microstructural readouts and clinical outcome above stenosis in patients with CSM.(A,B) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral corticospinal tract (CST) and posterior columns (PC), respectively) revealing associations between DTI indices and clinical outcome (left panel) between cervical level C2 and C3 (see Fig. 2A for reference). Colour bars indicate t-values. The right panels illustrate the corresponding regression models extracted from the peak-voxel within the significant cluster. Diffusivity parameters of the correlations are mean centered and adjusted for age. In particularly, (A) lower fractional anisotropy (FA) in left PC was associated with worse left ISNCSCI upper extremity light-touch score (UELT) and (B) lower FA in the left lateral CST was associated with lower Spinal Cord Independence Measure (SCIM).
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f4: Associations between tract-specific microstructural readouts and clinical outcome above stenosis in patients with CSM.(A,B) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral corticospinal tract (CST) and posterior columns (PC), respectively) revealing associations between DTI indices and clinical outcome (left panel) between cervical level C2 and C3 (see Fig. 2A for reference). Colour bars indicate t-values. The right panels illustrate the corresponding regression models extracted from the peak-voxel within the significant cluster. Diffusivity parameters of the correlations are mean centered and adjusted for age. In particularly, (A) lower fractional anisotropy (FA) in left PC was associated with worse left ISNCSCI upper extremity light-touch score (UELT) and (B) lower FA in the left lateral CST was associated with lower Spinal Cord Independence Measure (SCIM).

Mentions: In patients, significant associations were seen between macro- and microstructural MRI readouts and impairment. In particular, reduced PC area was associated with lower ISNCSCI UELT scores (R2 = 0.3559, p = 0.020) (Fig. 1E). Furthermore, lower FA in the left PC was associated with lower left ISNCSCI UELT scores (x: 0.0, y:−18.5, z:19.0, z score = 3.74, p = 0.003, extent = 198, FWE corrected) (Fig. 4A). Lower FA in the left lateral CST was associated with lower SCIM score (x:−3.5, y:−21.5, z:−3.0, z score = 3.68, p = 0.020, extent = 135, FWE corrected) (Fig. 4B).


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)

Associations between tract-specific microstructural readouts and clinical outcome above stenosis in patients with CSM.(A,B) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral corticospinal tract (CST) and posterior columns (PC), respectively) revealing associations between DTI indices and clinical outcome (left panel) between cervical level C2 and C3 (see Fig. 2A for reference). Colour bars indicate t-values. The right panels illustrate the corresponding regression models extracted from the peak-voxel within the significant cluster. Diffusivity parameters of the correlations are mean centered and adjusted for age. In particularly, (A) lower fractional anisotropy (FA) in left PC was associated with worse left ISNCSCI upper extremity light-touch score (UELT) and (B) lower FA in the left lateral CST was associated with lower Spinal Cord Independence Measure (SCIM).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f4: Associations between tract-specific microstructural readouts and clinical outcome above stenosis in patients with CSM.(A,B) Overlay of statistical parametric maps (p < 0.01 uncorrected, shown for descriptive purposes, masked by the lateral corticospinal tract (CST) and posterior columns (PC), respectively) revealing associations between DTI indices and clinical outcome (left panel) between cervical level C2 and C3 (see Fig. 2A for reference). Colour bars indicate t-values. The right panels illustrate the corresponding regression models extracted from the peak-voxel within the significant cluster. Diffusivity parameters of the correlations are mean centered and adjusted for age. In particularly, (A) lower fractional anisotropy (FA) in left PC was associated with worse left ISNCSCI upper extremity light-touch score (UELT) and (B) lower FA in the left lateral CST was associated with lower Spinal Cord Independence Measure (SCIM).
Mentions: In patients, significant associations were seen between macro- and microstructural MRI readouts and impairment. In particular, reduced PC area was associated with lower ISNCSCI UELT scores (R2 = 0.3559, p = 0.020) (Fig. 1E). Furthermore, lower FA in the left PC was associated with lower left ISNCSCI UELT scores (x: 0.0, y:−18.5, z:19.0, z score = 3.74, p = 0.003, extent = 198, FWE corrected) (Fig. 4A). Lower FA in the left lateral CST was associated with lower SCIM score (x:−3.5, y:−21.5, z:−3.0, z score = 3.68, p = 0.020, extent = 135, FWE corrected) (Fig. 4B).

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