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Tract-specific magnetization transfer ratio provides insights into the severity of degenerative cervical myelopathy

Spinal Cord volume 62, pages 700–707 (2024)Cite this article

Subjects

Abstract

Study design

Cross-sectional study.

Objectives

This study’s goal is to report whether Magnetization Transfer Ratio (MTR) can evaluate the severity of white matter (WM) injury in degenerative cervical myelopathy (DCM).

Setting

Laureate Institute of Brain Research, USA; Department of Neurosurgery, University of Oklahoma Health Sciences Center, USA.

Methods

27 DCM patients were aged-matched with 20 healthy controls (HC) and categorized into treatment groups based on modified Japanese Orthopedic Association (mJOA) severity (11 mild and 16 moderate/severe). Regional and tract MTRs were extracted from the two vertebral levels containing maximum compression within magnetization transfer images. MTR differences between groups were assessed using a one-way ANOVA or Kruskal-Wallis test. The association between MTR and mJOA measures was evaluated using Spearman’s correlation.

Results

Significant decreases in MTR were found between HC and moderate/severe groups in the overall (p = 0.0065) and ventral (p = 0.0009) WM regions; and ventral corticospinal (p = 0.0101), ventral reticulospinal (p = 0.0084), spinal lemniscus (p = 0.0079), and fasciculus cuneatus (p = 0.0219) tracts. The spinal lemniscus MTR also significantly decreased between HC and mild groups (p = 0.038). Ventral reticulospinal tract MTR correlated with upper (r = 0.439; p = 0.022) and lower (r = 0.386; p = 0.047) limb motor mJOA scores.

Conclusions

Significant tract-based MTR changes and correlations align with known DCM symptoms, are demonstrated to be lost at the regional level, and display the inhomogeneous compressive damage occurring within DCM spinal cords.

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Fig. 1: Region based magnetization transfer ratio (MTR) calculations between healthy controls (HC), and degenerative myelopathy (DCM) patients with mild and moderate/severe mJOA scores.
Fig. 2: Tract-based magnetization transfer ratio (MTR) calculations between healthy controls (HC), and degenerative myelopathy (DCM) patients with mild and moderate/severe mJOA scores.
Fig. 3: Correlations between modified Japanese Orthopedic Association (mJOA) measures and magnetization transfer ratio (MTR) values in the ventral region and ventral reticulospinal tract.

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Data availability

Due to the ongoing nature of data analysis, the datasets generated during and/or analyzed during the current study are not publicly available but are available from the corresponding author on reasonable request.

Code availability

Due to the ongoing nature of the analysis of the patient datasets, the code for this analysis is not yet publicly available. However, until such time that the code used for this analysis is made publicly available on GitHub, it is available upon reasonable request.

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Funding

This work was supported by the National Institutes of Health (NIH) NINDS K23:NS091430 and R01:NS129852-01A1 grants.

Author information

Authors and Affiliations

  1. Stephenson School of Biomedical Engineering, University of Oklahoma, Norman, OK, USA

    Grace Haynes & Lei Ding

  2. Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA

    Fauziyya Muhammad, Ali F. Khan, Sanaa Hameed, Hakeem Shakir & Zachary A. Smith

  3. Division of Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, USA

    Kenneth A. Weber 2nd

  4. Department of Orthopedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Michael Van Hal & Douglas Dickson

  5. Laureate Institute of Brain Research, Tulsa, OK, USA

    Michael Rohan

  6. Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Yasin Dhaher

  7. Department of Radiology, Northwestern Feinberg School of Medicine, Chicago, IL, USA

    Todd Parrish

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  1. Grace Haynes
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Contributions

Concept/Idea/Design: GH, FM, TP, YD, KAW, ZAS; Data Collection: Data Collection: GH, FM, AFK, SH; Data Analysis: FM, GH; Writing: GH, FM, LD, KAW, ZAS; Resources: HS, MVH, DD, MR, ZAS.

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Correspondence to Grace Haynes.

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Haynes, G., Muhammad, F., Weber, K.A. et al. Tract-specific magnetization transfer ratio provides insights into the severity of degenerative cervical myelopathy. Spinal Cord 62, 700–707 (2024). https://doi.org/10.1038/s41393-024-01036-y

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