Assessing structure and function of myelin in cervical spondylotic myelopathy: Evidence of demyelination.

Abstract:

PURPOSE:To assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques. METHODS:Somatosensory evoked potentials (SSEPs) and MWI were acquired in 14 patients with CSM and 18 age-matched healthy controls. MWI was performed on a 3.0T whole body magnetic resonance scanner. Myelin water fraction (MWF) was extracted for the dorsal columns and whole cord. SSEPs and MWF were also compared with conventional MRI outcomes, including T2 signal intensity, compression ratio, maximum spinal cord compression (MSCC), and maximum canal compromise (MCC). RESULTS:Group analysis showed marked differences in T2 signal intensity, compression ratio, MSCC, and MCC between healthy controls and patients with CSM. There were no group differences in MWF and SSEP latencies. However, patients with CSM with pathologic SSEPs exhibited reduction in MWF (p < 0.05). MWF was also correlated with SSEP latencies. CONCLUSION:Our findings provide evidence of decreased myelin content in the spinal cord associated with impaired spinal cord conduction in patients with CSM. While conventional MRI are of great value to define the extent of cord compression, they show a limited correlation with functional deficits (i.e., delayed SSEPs). MWI provides independent and complementary readouts to spinal cord compression, with a high specificity to detect impaired conduction.

journal_name

Neurology

journal_title

Neurology

authors

Liu H,MacMillian EL,Jutzeler CR,Ljungberg E,MacKay AL,Kolind SH,Mädler B,Li DKB,Dvorak MF,Curt A,Laule C,Kramer JLK

doi

10.1212/WNL.0000000000004197

subject

Has Abstract

pub_date

2017-08-08 00:00:00

pages

602-610

issue

6

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000004197

journal_volume

89

pub_type

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