In vivo Molecular Signatures of Cervical Spinal Cord Pathology in Degenerative Compression

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Authors

HORÁK Tomáš HORÁKOVÁ Magda SVÁTKOVÁ Alena KADAŇKA Zdeněk KUDLIČKA Petr VALOSEK Jan ROHAN Tomáš KEŘKOVSKÝ Miloš VLČKOVÁ Eva KADAŇKA Zdeněk DEELCHAND Dinesh K. HENRY Pierre-Gilles BEDNAŘÍK Josef BEDNAŘÍK Petr

Year of publication 2021
Type Article in Periodical
Magazine / Source Journal of Neurotrauma
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.liebertpub.com/doi/10.1089/neu.2021.0151
Doi http://dx.doi.org/10.1089/neu.2021.0151
Keywords cervical spinal cord; compression; degenerative magnetic resonance; myelopathy; spectroscopy
Description 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.
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