AUTHOR=Pfender Nikolai , Jutzeler Catherine R. , Hubli Michèle , Scheuren Paulina S. , Pfyffer Dario , Zipser Carl M. , Rosner Jan , Friedl Susanne , Sutter Reto , Spirig José M. , Betz Michael , Schubert Martin , Seif Maryam , Freund Patrick , Farshad Mazda , Curt Armin , Hupp Markus 

TITLE=Potential thresholds of critically increased cardiac-related spinal cord motion in degenerative cervical myelopathy

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1411182

DOI=10.3389/fneur.2024.1411182

ISSN=1664-2295

ABSTRACT=Introduction: New diagnostic techniques are a substantial research focus in degenerative cervical myelopathy (DCM). This cross-sectional study determined the significance of cardiac-related spinal cord motion and the extent of spinal stenosis as indicators of mechanical strain on the cord. Methods: Eighty-four DCM patients underwent MRI/clinical assessments and were classified as MRI+ [T2-weighted (T2w) hyperintense lesion in MRI] or MRI-(no T2w-hyperintense lesion). Cord motion (displacement assessed by phase-contrast MRI) and spinal stenosis [adapted spinal canal occupation ratio (aSCOR)] were related to neurological (sensory/motor) and neurophysiological readouts [contact heat evoked potentials (CHEPs)] by receiver operating characteristic (ROC) analysis. Results: MRI+ patients (N=31; 36.9 %) were more impaired compared to MRI-patients (N=53; 63.1%) based on the modified Japanese Orthopedic Association (mJOA) subscores for upper (MRI+ [median (Interquartile range)]: 4 (4-5); MRI-: 5 (5-5); p<0.01) and lower extremity (MRI+: 6 (6-7); MRI-: 7 (6-7); p=0.03) motor dysfunction and the monofilament score (MRI+: 21 (18-23); MRI-: 24 (22-24); p<0.01). Both patient groups showed similar extent of cord motion and stenosis. Only in the MRI-group displacement identified patients with pathologic assessments (trunk/lower extremity pin prick score (T/LEPP