Fractional anisotropy to quantify cervical spondylotic myelopathy severity

Authors

Rory K. Murphy, Department of Neurosurgery, Washington University, St. Louis, MO, USA.Follow
Peng Sun, Department of Radiology, Washington University, St. Louis, MO, USA.
Rowland H. Han, Washington University School of Medicine, St. Louis, MO, USA.
Kim J. Griffin, Department of Radiology, Washington University, St. Louis, MO, USA.
Joanne Wagner, Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA.
Chester K. Yarbrough, Department of Neurosurgery, Washington University, St. Louis, MO, USA.
Neill M. Wright, Department of Neurosurgery, Washington University, St. Louis, MO, USA.
Ian G. Dorward, Department of Neurosurgery, Washington University, St. Louis, MO, USA.
K Daniel Riew, Department of Orthopedic Surgery, Columbia University, New York, NY, USA.
Michael P. Kelly, Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA.Follow
Paul Santiago, Department of Neurosurgery, Washington University, St. Louis, MO, USA.
Lukas P. Zebala, Department of Orthopedic Surgery, Washington University, St. Louis, MO, USA.
Kathryn Trinkaus, Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA.
Wilson Z. Ray, Department of Neurosurgery, Washington University, St. Louis, MO, USA - rayz@wudosis.wustl.edu.
Sheng-Kwei Song, Department of Radiology, Washington University, St. Louis, MO, USA.

Document Type

Article

Abstract

BACKGROUND: A number of clinical tools exist for measuring the severity of cervical spondylotic myelopathy (CSM). Several studies have recently described the use of non-invasive imaging biomarkers to assess severity of disease. These imaging markers may provide an additional tool to measure disease progression and represent a surrogate marker of response to therapy. Correlating these imaging biomarkers with clinical quantitative measures is critical for accurate therapeutic stratification and quantification of axonal injury. METHODS: Fourteen patients and seven healthy control subjects were enrolled. Patients were classified as mildly (7) or moderately (7) impaired based on Modified Japanese Orthopedic Association Scale. All patients underwent diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI) analyses. In addition to standard neurological examination, all participants underwent 30-m Walking Test, 9-hole Peg Test (9HPT), grip strength, key pinch, and vibration sensation thresholds in the index finger and great toe. Differences in assessment scores between controls, mild and moderate CSM patients were correlated with DTI and DBSI derived fractional anisotropy (FA). RESULTS: Clinically, 30-meter walking times were significantly longer in the moderately impaired group than in the control group. Maximum 9HPT times were significantly longer in both the mildly and moderately impaired groups as compared to normal controls. Scores on great toe vibration sensation thresholds were lower in the mildly impaired and moderately impaired groups as compared to controls. We found no clear evidence for any differences in minimum grip strength, minimum key pinch, or index finger vibration sensation thresholds. There were moderately strong associations between DTI and DBSI FA values and 30-meter walking times and 9HPT. CONCLUSIONS: The 30-m Walking Test and 9HPT were both moderately to strongly associated with DTI/DBSI FA values. FA may represent an additional measure to help differentiate and stratify patients with mild or moderate CSM.

Medical Subject Headings

Adult; Anisotropy; Cervical Vertebrae; Diffusion Tensor Imaging (methods); Female; Humans; Magnetic Resonance Imaging (methods); Male; Middle Aged; Neuroimaging (methods); Spinal Cord Compression (diagnostic imaging, etiology); Spinal Cord Diseases (diagnostic imaging, etiology); Spondylosis (complications)

Publication Date

8-1-2018

Publication Title

Journal of neurosurgical sciences

E-ISSN

1827-1855

Volume

62

Issue

4

First Page

406

Last Page

412

PubMed ID

27149369

Digital Object Identifier (DOI)

10.23736/S0390-5616.16.03678-X

Recommended Citation

Murphy, Rory K.; Sun, Peng; Han, Rowland H.; Griffin, Kim J.; Wagner, Joanne; Yarbrough, Chester K.; Wright, Neill M.; Dorward, Ian G.; Riew, K Daniel; Kelly, Michael P.; Santiago, Paul; Zebala, Lukas P.; Trinkaus, Kathryn; Ray, Wilson Z.; and Song, Sheng-Kwei, "Fractional anisotropy to quantify cervical spondylotic myelopathy severity" (2018). Neurosurgery. 1474.
https://scholar.barrowneuro.org/neurosurgery/1474