Diffusion magnetic resonance imaging reveals tract‐specific microstructural correlates of electrophysiological impairments in non‐myelopathic and myelopathic spinal cord compression

Background and purpose Non‐myelopathic degenerative cervical spinal cord compression (NMDC) frequently occurs throughout aging and may progress to potentially irreversible degenerative cervical myelopathy (DCM). Whereas standard clinical magnetic resonance imaging (MRI) and electrophysiological meas...

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Bibliographic Details
Published in:European journal of neurology 2021-11, Vol.28 (11), p.3784-3797
Main Authors: Valošek, Jan, Labounek, René, Horák, Tomáš, Horáková, Magda, Bednařík, Petr, Keřkovský, Miloš, Kočica, Jan, Rohan, Tomáš, Lenglet, Christophe, Cohen‐Adad, Julien, Hluštík, Petr, Vlčková, Eva, Kadaňka, Zdeněk, Bednařík, Josef, Svatkova, Alena
Format: Article
Language:English
Subjects:
Abnormalities
Aging
Central nervous system diseases
Compression
Compression tests
Degeneration
Demyelination
Diffusion
diffusion magnetic resonance imaging
diffusion tensor imaging
Electromyography
Longitudinal studies
Magnetic resonance imaging
Medical imaging
Microstructure
Neurological complications
Orthopedics
Patients
Resonance
Spinal cord
spinal cord compression
Substantia grisea
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Summary:Background and purpose Non‐myelopathic degenerative cervical spinal cord compression (NMDC) frequently occurs throughout aging and may progress to potentially irreversible degenerative cervical myelopathy (DCM). Whereas standard clinical magnetic resonance imaging (MRI) and electrophysiological measures assess compression severity and neurological dysfunction, respectively, underlying microstructural deficits still have to be established in NMDC and DCM patients. The study aims to establish tract‐specific diffusion MRI markers of electrophysiological deficits to predict the progression of asymptomatic NMDC to symptomatic DCM. Methods High‐resolution 3 T diffusion MRI was acquired for 103 NMDC and 21 DCM patients compared to 60 healthy controls to reveal diffusion alterations and relationships between tract‐specific diffusion metrics and corresponding electrophysiological measures and compression severity. Relationship between the degree of DCM disability, assessed by the modified Japanese Orthopaedic Association scale, and tract‐specific microstructural changes in DCM patients was also explored. Results The study identified diffusion‐derived abnormalities in the gray matter, dorsal and lateral tracts congruent with trans‐synaptic degeneration and demyelination in chronic degenerative spinal cord compression with more profound alterations in DCM than NMDC. Diffusion metrics were affected in the C3‐6 area as well as above the compression level at C3 with more profound rostral deficits in DCM than NMDC. Alterations in lateral motor and dorsal sensory tracts correlated with motor and sensory evoked potentials, respectively, whereas electromyography outcomes corresponded with gray matter microstructure. DCM disability corresponded with microstructure alteration in lateral columns. Conclusions Outcomes imply the necessity of high‐resolution tract‐specific diffusion MRI for monitoring degenerative spinal pathology in longitudinal studies. Tract‐specific diffusion magnetic resonance imaging revealed microstructural changes in non‐myelopathic and myelopathic degenerative spinal cord compression compared to healthy controls. Alterations were found in dorsal and lateral columns as well as gray matter and correlated with relevant electrophysiological abnormalities and clinical modified Japanese Orthopaedic Association scale.
ISSN:1351-5101
1468-1331
DOI:10.1111/ene.15027