Degenerative cervical myelopathy (DCM) is a severe consequence of degenerative cervical spinal cord (CSC) compression. The non-myelopathic stage of compression (NMDC) is highly prevalent and often progresses to disabling DCM. This study aims to disclose markers of progressive neurochemical alterations in NMDC and DCM by utilizing an approach based on state-of-the-art proton magnetic resonance spectroscopy (1H-MRS). Proton-MRS data were prospectively acquired from 73 participants with CSC compression and 47 healthy controls (HCs). The MRS voxel was centered at the C2 level. Compression-affected participants were clinically categorized as NMDC and DCM, radiologically as mild (MC) or severe (SC) compression. CSC volumes and neurochemical concentrations were compared between cohorts (HC vs. NMDC vs. DCM and HC vs. MC vs. SC) with general linear models adjusted for age and height (pFWE < 0.05) and correlated to stenosis severity, electrophysiology, and myelopathy symptoms (p < 0.05). Whereas the ratio of total creatine (tCr) to total N-acetylaspartate (tNAA) increased in NMDC (+11%) and in DCM (+26%) and SC (+21%), myo-inositol/tNAA, glutamate + glutamine/tNAA, and volumes changed only in DCM (+20%, +73%, and -14%) and SC (+12%, +46%, and -8%, respectively) relative to HCs. Both tCr/tNAA and myo-inositol/tNAA correlated with compression severity and volume (-0.376 < r < -0.259). Myo-inositol/tNAA correlated with myelopathy symptoms (r = -0.670), whereas CSC volume did not. Short-echo 1H-MRS provided neurochemical signatures of CSC impairment that reflected compression severity and clinical significance. Whereas volumetry only reflected clinically manifest myelopathy (DCM), MRS detected neurochemical changes already before the onset of myelopathy symptoms.
|Original language||English (US)|
|Number of pages||12|
|Journal||Journal of neurotrauma|
|State||Published - Nov 1 2021|
Bibliographical noteFunding Information:
The Center for Magnetic Resonance Research, University of Minnesota is supported, in part, by NIH Center grants P41EB027061 and P30NS076408.
We acknowledge the core facility of the Multimodal and Functional Imaging Laboratory, Masaryk University, CEITEC supported by MEYS CR (LM2018129 Czech-BioImaging). Access to computing and storage facilities owned by parties and projects contributing to the National Grid Infrastructure MetaCentrum provided under the program ‘‘Projects of Large Research, Development, and Innovations Infrastructures’’ (CESNET LM2015042), is greatly appreciated.
This research was funded by Czech Health Research Council grants ref. NV18-04-00159 and by the Ministry of Health of the Czech Republic project for conceptual development in research organizations, ref. 65269705 (University Hospital, Brno, Czech Republic).
A.S. has received funding from the European Union’s Horizon 2020 research and innovation program under a Marie Sk1odowska-Curie grant agreement (no. 794986). P.B. was partially supported by the European Union’s Horizon 2020 research and innovation program under a Marie Sk1odowska-Curie grant agreement (no. 846793) and by a NARSAD Young Investigator Grant from the Brain and Behavior Research Foundation (no. 27238).
© Tomas Horak et al., 2021; Published by Mary Ann Liebert, Inc. 2021.
- cervical spinal cord, compression, degenerative
- magnetic resonance