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Metabolite, functional profile of patients with CSM may be used to discriminate mild, moderate disease
Results from this recently published study indicated the N-acetylaspartate to creatine ratio and the volume of activation in the primary motor cortex can be used to differentiate between mild and moderate cervical spondylotic myelopathy.
Researchers identified 28 patients with cervical spondylotic myelopathy who underwent 3-T MRI scans before surgery and at 6 months postoperatively. The modified Japanese Orthopaedic Association questionnaire was used to determine severity of disease. Investigators also performed two MRI scans 6 months apart in 10 healthy control patients. In the patient cohort, investigators measured the metabolite levels from the primary motor cortex (M1) contralateral to the greater deficit side. In the controls, they measured both sides. A right finger-tapping paradigm was used to assess motor function.
Findings showed patients with mild CSM compared with those with moderate CSM had a lower N-acetylaspartate to creatine (NAA/Cr) ratio, which demonstrated mitochondrial dysfunction. Investigators noted that following surgery, the NAA/Cr levels in patients with moderate CSM decreased to levels similar to those observed patients with mild CSM. Prior to surgery, a larger volume of activation was seen among patients with mild CSM in the M1 compared with patients with moderate CSM; whereas postoperatively, the volume of activation was similar in both groups and had moved toward the primary sensory cortex. – by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.