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Article: Diffusion tensor imaging of somatosensory tract in cervical spondylotic myelopathy and its link with electrophysiological evaluation

TitleDiffusion tensor imaging of somatosensory tract in cervical spondylotic myelopathy and its link with electrophysiological evaluation
Authors
KeywordsMicrostructure
Spinal cord
Fractional anisotropy
Diffusion tensor imaging
Cervical spondylotic myelopathy
Issue Date2014
Citation
The Spine Journal, 2014, v. 14, n. 8, p. 1493-1500 How to Cite?
AbstractBackground and context Abnormal somatosensory evoked potential (SEP) (ie, prolonged latency) has been associated with poor surgical prognosis of cervical spondylotic myelopathy (CSM). Purpose To further characterize the extent of microstructural damage to the somatosensory tract in CSM patients using diffusion tensor imaging (DTI). Study design/setting Retrospective study. Patient sample A total of 40 volunteers (25 healthy subjects and 15 CSM patients). Outcome measures Clinical, electrophysiological, and radiological evaluations were performed using the modified Japanese Orthopedic Association (mJOA) scoring system, SEP, and cord compression ratio in anatomic magnetic resonance (MR) images, respectively. Axial diffusion MR images were taken using a pulsed gradient, spin-echo-echo-planar imaging sequence with a 3-T MR system. The diffusion indices in different regions of the spinal cord were measured. Methods Comparison of diffusion indices among healthy and myelopathic spinal cord with intact and impaired SEP responses were performed using one-way analysis of variance. Results In healthy subjects, fractional anisotropy (FA) values were higher in the dorsal (0.73±0.11) and lateral columns (0.72±0.13) than in the ventral column of white matter (0.58±0.10) (eg, at C4/5) (p<.05). FA was dramatically dropped in the dorsal (0.54±0.16) and lateral columns (0.51±0.13) with little change in the ventral column (0.48±0.15) at the compressive lesions in CSM patients. There were no significant differences in the mJOA scores or cord compression ratios between CSM patients with or without abnormal SEP. However, patients with abnormal SEP showed an FA decrease in the dorsal column cephalic to the lesion (0.56±0.06) (ie, at C1/2, compared with healthy subjects [0.66±0.02]), but the same decrease was not observed for those without a SEP abnormality (0.67±0.02). Conclusion Spinal tracts were not uniformly affected in the myelopathic cervical cord. Changes in diffusion indices could delineate focal or extensive myelopathic lesions in CSM, which could account for abnormal SEP. DTI analysis of spinal tracts might provide additional information not available from conventional diagnostic tools for prognosis of CSM. © 2014 Elsevier Inc. All rights reserved.
Persistent Identifierhttp://hdl.handle.net/10722/205814
ISSN
2015 Impact Factor: 2.66
2015 SCImago Journal Rankings: 1.153
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorWen, Chunyi-
dc.contributor.authorCui, Jiaolong-
dc.contributor.authorMak, Kincheung-
dc.contributor.authorLuk, Keith D K-
dc.contributor.authorHu, Yong-
dc.date.accessioned2014-10-06T08:02:24Z-
dc.date.available2014-10-06T08:02:24Z-
dc.date.issued2014-
dc.identifier.citationThe Spine Journal, 2014, v. 14, n. 8, p. 1493-1500-
dc.identifier.issn1529-9430-
dc.identifier.urihttp://hdl.handle.net/10722/205814-
dc.description.abstractBackground and context Abnormal somatosensory evoked potential (SEP) (ie, prolonged latency) has been associated with poor surgical prognosis of cervical spondylotic myelopathy (CSM). Purpose To further characterize the extent of microstructural damage to the somatosensory tract in CSM patients using diffusion tensor imaging (DTI). Study design/setting Retrospective study. Patient sample A total of 40 volunteers (25 healthy subjects and 15 CSM patients). Outcome measures Clinical, electrophysiological, and radiological evaluations were performed using the modified Japanese Orthopedic Association (mJOA) scoring system, SEP, and cord compression ratio in anatomic magnetic resonance (MR) images, respectively. Axial diffusion MR images were taken using a pulsed gradient, spin-echo-echo-planar imaging sequence with a 3-T MR system. The diffusion indices in different regions of the spinal cord were measured. Methods Comparison of diffusion indices among healthy and myelopathic spinal cord with intact and impaired SEP responses were performed using one-way analysis of variance. Results In healthy subjects, fractional anisotropy (FA) values were higher in the dorsal (0.73±0.11) and lateral columns (0.72±0.13) than in the ventral column of white matter (0.58±0.10) (eg, at C4/5) (p<.05). FA was dramatically dropped in the dorsal (0.54±0.16) and lateral columns (0.51±0.13) with little change in the ventral column (0.48±0.15) at the compressive lesions in CSM patients. There were no significant differences in the mJOA scores or cord compression ratios between CSM patients with or without abnormal SEP. However, patients with abnormal SEP showed an FA decrease in the dorsal column cephalic to the lesion (0.56±0.06) (ie, at C1/2, compared with healthy subjects [0.66±0.02]), but the same decrease was not observed for those without a SEP abnormality (0.67±0.02). Conclusion Spinal tracts were not uniformly affected in the myelopathic cervical cord. Changes in diffusion indices could delineate focal or extensive myelopathic lesions in CSM, which could account for abnormal SEP. DTI analysis of spinal tracts might provide additional information not available from conventional diagnostic tools for prognosis of CSM. © 2014 Elsevier Inc. All rights reserved.-
dc.languageeng-
dc.relation.ispartofThe Spine Journal-
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in Spine Journal. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Spine Journal, 2014, v. 14, n. 8, p. 1493-1500. DOI: 10.1016/j.spinee.2013.08.052-
dc.rightsElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/spinee-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectMicrostructure-
dc.subjectSpinal cord-
dc.subjectFractional anisotropy-
dc.subjectDiffusion tensor imaging-
dc.subjectCervical spondylotic myelopathy-
dc.titleDiffusion tensor imaging of somatosensory tract in cervical spondylotic myelopathy and its link with electrophysiological evaluation-
dc.typeArticle-
dc.description.naturepostprint-
dc.identifier.doi10.1016/j.spinee.2013.08.052-
dc.identifier.pmid24321168-
dc.identifier.scopuseid_2-s2.0-84905437579-
dc.identifier.hkuros230632-
dc.identifier.hkuros246381-
dc.identifier.hkuros249913-
dc.identifier.volume14-
dc.identifier.issue8-
dc.identifier.spage1493-
dc.identifier.epage1500-
dc.identifier.eissn1878-1632-
dc.identifier.isiWOS:000341304300016-

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