Abstract:
BACKGROUND:Advanced cervical spondylosis (CS) can cause structural damage to the spinal cord resulting in long-term neurological impairment including neck pain and motor weakness. We hypothesized long-term structural reorganization within the brain in patients with CS. OBJECTIVE:To explore the associations between cortical thickness, subcortical volumes, neurological symptoms, and pain severity in CS patients with or without myelopathy and healthy controls (HCs). METHODS:High-resolution T1-weighted structural magnetic resonance imaging (MRI) scans from 26 CS patients and 45 HCs were acquired. Cortical thickness and subcortical volumes were computed and compared to the modified Japanese Orthopedic Association (mJOA) and the Neck Disability Index (NDI) scores. RESULTS:Cortical thinning within the superior frontal gyrus, anterior cingulate, precuneus, and reduction in putamen volume were associated with worsening neurological and pain symptoms. Among the strongest associations were cortical thickness within the left precuneus (R2 = 0.34) and left and right putamen (R2 = 0.43, 0.47, respectively) vs mJOA, and the left precuneus (R2 = 0.55), insula (R2 = 0.57), and right putamen (R2 = 0.54) vs NDI (P ≤ .0001 for all). Cortical thickness along Brodmann areas 3a, 4a, and 4p were also moderately associated with mJOA. Preliminary evidence also suggests that patients with CS may undergo cortical atrophy at a faster rate than HCs. CONCLUSION:Patients with CS appear to exhibit cortical thinning and atrophy with worsening neurological and pain symptoms in specific brain regions associated with sensorimotor and pain processing.
journal_name
Neurosurgeryjournal_title
Neurosurgeryauthors
Woodworth DC,Holly LT,Mayer EA,Salamon N,Ellingson BMdoi
10.1093/neuros/nyy066subject
Has Abstractpub_date
2019-03-01 00:00:00pages
588-598issue
3eissn
0148-396Xissn
1524-4040pii
4934777journal_volume
84pub_type
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