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  Tracking white and gray matter degeneration along the spinal cord axis in degenerative cervical myelopathy

Vallotton, K., David, G., Hupp, M., Pfender, N., Cohen-Adad, J., Fehlings, M. G., et al. (2021). Tracking white and gray matter degeneration along the spinal cord axis in degenerative cervical myelopathy. Journal of Neurotrauma, 38(21), 2978-2987. doi:10.1089/neu.2021.0148.

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Vallotton, Kevin1, Author
David, Gergely1, Author
Hupp, Markus1, Author
Pfender, Nikolai1, Author
Cohen-Adad, Julien2, 3, 4, Author
Fehlings, Michael G.5, Author
Samson, Rebecca S.6, Author
Wheeler-Kingshott, Claudia A.M. Gandini6, 7, 8, Author
Curt, Armin1, Author
Freund, Patrick1, 9, 10, 11, Author           
Seif, Maryam1, 9, Author
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
2NeuroPoly Lab, Institute of Biomedical Engineering, École Polytechnique de Montréal, QC, Canada, ou_persistent22              
3Unité de neuroimagerie fonctionnelle, Centre de recherche de l'Institut universitaire de gériatrie de Montréal, QC, Canada, ou_persistent22              
4Mila – Quebec Artificial Intelligence Institute, Montréal, QC, Canada, ou_persistent22              
5Spine Program, Department of Surgery, University of Toronto, ON, Canada, ou_persistent22              
6NMR Research Unit, Queen Square Multiple Sclerosis Centre, Institute of Neurology, University College London, United Kingdom, ou_persistent22              
7Department of Brain and Behavioral Sciences, University of Pavia, Italy, ou_persistent22              
8Neurological Institute Foundation Casimiro Mondino, Pavia, Italy, ou_persistent22              
9Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              
10Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              
11Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, United Kingdom, ou_persistent22              


Free keywords: DCM; DTI; Biomarker; Spinal cord quantitative MRI
 Abstract: This study aims to determine tissue-specific neurodegeneration across the spinal cord in patients with mild-moderate degenerative cervical myelopathy (DCM). Twenty-four mild-moderate DCM and 24 healthy subjects were recruited. In patients, a T2-weighted scan was acquired at the compression site, whereas 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 gray 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 magnetic resonance imaging (MRI) readouts and electrophysiological and clinical outcomes. Twenty patients were classified with mild and 4 with moderate DCM using the mJOA scale. The most frequent site of compression was at the C5–C6 level, with maximum cord compression of 38.73% ± 11.57%. Ten patients showed imaging evidence of cervical myelopathy. In the cervical cord, WM and GM atrophy and WM microstructural changes were evident, whereas 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. In conclusion, tissue-specific neurodegeneration revealed by quantitative MRI is already apparent across the spinal cord in mild-moderate DCM before the onset of severe clinical impairments. WM microstructural changes are particularly sensitive to remote pathologically and clinically eloquent changes in DCM.


Language(s): eng - English
 Dates: 2021-08-032021-11
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1089/neu.2021.0148
Other: epub 2021
PMID: 34238034
 Degree: -



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Project name : -
Grant ID : WFL-CH-007/14; WFL-CH-19/20
Funding program : Wings for Life
Funding organization : -
Project name : -
Grant ID : 32NE30_173678
Funding program : ERA-NET NEURON
Funding organization : -
Project name : -
Grant ID : 681094
Funding program : Horizon 2020
Funding organization : European Union

Source 1

Title: Journal of Neurotrauma
  Other : J. Neurotrauma
Source Genre: Journal
Publ. Info: New York, NY : M.A. Liebert
Pages: - Volume / Issue: 38 (21) Sequence Number: - Start / End Page: 2978 - 2987 Identifier: ISSN: 0897-7151
CoNE: https://pure.mpg.de/cone/journals/resource/954925561573