Article
Cortical volume reductions as a sign of secondary cerebral and cerebellar impairment in patients with degenerative cervical myelopathy
Kortikale Volumenreduktion als Zeichen einer zerebralen und zerebellären sekundären Schädigung bei Patienten mit degenerativer zervikaler Myelopathie
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Published: | June 4, 2021 |
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Objective: This study investigated supra- and infratentorial structural gray and white matter (GM, WM) alterations in patients with degenerative cervical myelopathy (DCM) as an indicator of secondary harm due to chronic cervical cord compression and micro traumata.
Methods: With MRI-based anatomical assessment and subsequent voxel-based morphometry analyses, pre- and postoperative volume alterations in the primary motor cortex (MI), the primary somatosensory cortex (SI), the supplementary motor area (SMA), and the cerebellum were analyzed in 43 DCM patients and 20 controls. Disease-related symptom severity was assessed by the modified Japanese Orthopedic Association scale (mJOA). Symptom severity-based brain volume alterations were explored, as well as their association with the clinical status.
Results: Patients had lower mJOA scores (p<.001) and lower GM volume than controls in SI (p<.05) and cerebellar regions (p<.001). Symptom severity-based subgroup analyses revealed volume reductions across all investigated GM ROIs in patients with severe clinical symptoms (all p<.05), as well as already present atrophy in patients with moderate symptom severity (p<.05). Clinical symptoms in DCM were associated with cortical and cerebellar volume reduction.
Conclusion: GM volume alterations may serve as an indicator of both disease severity and ongoing disease progression in DCM and should be considered in further patient care and treatment monitoring.