In vivo molecular signatures of cervical spinal cord pathology in degenerative compression.

Degenerative cervical myelopathy (DCM) is a severe consequence of degenerative cervical spinal cord (CSC) compression. The non-myelopathic stage of compression (NMDC) is highly prevalent and often progresses to disabling DCM. This study aims to disclose markers of progressive neurochemical alterations in NMDC and DCM by utilizing an approach based on state-of-the-art proton magnetic resonance spectroscopy (1H-MRS). Proton-MRS data were prospectively acquired from 73 participants with CSC compression and 47 healthy controls. Compression-affected participants were clinically categorized as NMDC and DCM, radiologically as mild (MC) or severe (SC) compression. MRS voxel was centered at C2 level. CSC volumes and neurochemicals were quantified and compared between HCNMDCDCM and HCMCSC, with general linear models adjusted for age and height effects (pFWE <0.05) and correlated to stenosis severity, electrophysiology, and myelopathy symptoms (p <0.05). Ratio of total creatine (tCr) to total N-acetylaspartate (tNAA) increased in NMDC (+11%) and in DCM (+26%) and SC (+21%). Myo-inositol/tNAA, glutamate+glutamine/tNAA and volumes showed change only in DCM (+20%, +73%, and -14%) and SC (+12%, +46%, and -8%, respectively) relative to HC. Both tCr/tNAA and myo-inositol/tNAA correlated with compression severity and volume (-0.376

Keywords:

• Myelopathy
• Neurochemical
• Spinal cord injury
• Gastroenterology
• Internal medicine
• Medicine
• Electromyography
• Glutamine
• Spinal cord
• In vivo magnetic resonance spectroscopy
• Clinical significance

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