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Neurodegeneration within the rostral spinal cord is associated with brain gray matter volume atrophy in the early stage of cervical spondylotic myelopathy

Spinal Cord (2024)Cite this article

Subjects

Abstract

Study design

Case-control study.

Objectives

Investigating the association between neurodegeneration within rostral spinal cord and brain gray matter volume (GMV) and assessing the relationship between remote neurodegenerative changes and clinical outcomes at the early phase of Cervical Spondylotic Myelopathy (CSM).

Setting

University/hospital.

Methods

Using Spinal Cord Toolbox, spinal cord morphometrics (cross-sectional area [CSA], gray matter area [GMA], white matter area [WMA]) of 40 patients with CSM and 28 healthy controls (HCs) were computed and compared using two-sample t test. Brain GMV of the two groups was analyzed using voxel-based morphometry approach. Pearson’s correlation between spinal cord morphometrics and altered brain GMV and Spearman’s relationship between remote neurodegenerations and clinical outcomes were conducted in CSM group.

Results

Compared to HCs, CSA and WMA at C2/3 and GMV in right postcentral gyrus (PoCG.R) and left supplementary motor area (SMA.L) were significantly decreased in patients with CSM. CSA and WMA at C2/3 were associated with GMV in SMA.L and MCG.R in patients with CSM. CSA at C2/3 and GMV in PoCG.R were related to modified Japanese Orthopedic Association score in patients with CSM.

Conclusions

The associations between CSA and WMA at C2/3 and GMV in SMA.L and MCG.R suggest a concordant change pattern and adaptive mechanisms for neuronal plasticity underlying remote neurodegeneration in early CSM. The atrophy of CSA at C2/3 and GMV loss in PoCG.R can serve as potential neuroimaging biomarkers of early structural changes within spinal cord and brain preceding marked clinical disabilities in patients with CSM.

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Fig. 1: Significant changes in rostral spinal morphometrics occur in patients with CSM compared to HCs.
Fig. 2: Significant changes in brain GMV occur in patients with CSM compared to HCs.
Fig. 3: The correlation analysis results.

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Data availability

The data that support the findings of this study are available from the corresponding author, Yunfei Zha, on reasonable request.

Code availability

The codes that ran on the SCT and R statistical and computing software were available from the corresponding author, Yunfei Zha, on reasonable request.

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Acknowledgements

We would like to thank all participants for their time and effort. We are deeply grateful to programmer Wei Zhao from ShuKun Technology for her help with installing the Spinal Cord Toolbox software.

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Authors and Affiliations

  1. Department of Radiological, Renmin Hospital of Wuhan University, Wuhan, Hubei, China

    Cuili Kuang & Yunfei Zha

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  1. Cuili Kuang
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Contributions

CK: acquired and analyzed the data, interpreted the results, wrote the manuscript. YZ: designed the study, performed the clinical evaluation of individuals, revised the manuscript. All authors read and approved the submitted manuscript.

Corresponding author

Correspondence to Yunfei Zha.

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The authors declare no competing interests.

Ethical approval

The study was approved by the ethics review board of Renmin Hospital of Wuhan University and was conducted in accordance with the Declaration of Helsinki. We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research.

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Kuang, C., Zha, Y. Neurodegeneration within the rostral spinal cord is associated with brain gray matter volume atrophy in the early stage of cervical spondylotic myelopathy. Spinal Cord (2024). https://doi.org/10.1038/s41393-024-00971-0

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