%0 Journal Article
%T Potential thresholds of critically increased cardiac-related spinal cord motion in degenerative cervical myelopathy.
%A Pfender N
%A Jutzeler CR
%A Hubli M
%A Scheuren PS
%A Pfyffer D
%A Zipser CM
%A Rosner J
%A Friedl S
%A Sutter R
%A Spirig JM
%A Betz M
%A Schubert M
%A Seif M
%A Freund P
%A Farshad M
%A Curt A
%A Hupp M
%J Front Neurol
%V 15
%N 0
%D 2024
%M 38978814
%F 4.086
%R 10.3389/fneur.2024.1411182
%X <B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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): AUC = 0.67, p = 0.03; CHEPs: AUC = 0.73, p = 0.01]. Cord motion thresholds: T/LEPP: 1.67 mm (sensitivity 84.6%, specificity 52.5%); CHEPs: 1.96 mm (sensitivity 83.3%, specificity 65.6%). The aSCOR failed to show any relation to the clinical assessments.<BR><B>UNASSIGNED: </B>These findings affirm cord motion measurements as a promising additional biomarker to improve the clinical workup and to enable timely surgical treatment particularly in MRI- DCM patients.<BR><B>UNASSIGNED: </B>www.clinicaltrials.gov, NCT02170155.