{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:58:10Z","timestamp":1791979090725,"version":"4.4.0"},"reference-count":41,"publisher":"SAGE Publications","issue":"21","license":[{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,10,14]],"date-time":"2021-10-14T00:00:00Z","timestamp":1634169600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:p>This study aims to determine tissue-specific neurodegeneration across the spinal cord in patients with mild-moderate degenerative cervical myelopathy (DCM). Twenty-four mild-moderate DCM and 24 healthy subjects were recruited. In patients, a T2-weighted scan was acquired at the compression site, whereas in all participants a T2*-weighted and diffusion-weighted scan was acquired at the cervical level (C2\u2013C3) and in the lumbar enlargement (i.e., rostral and caudal to the site of compression). We quantified intramedullary signal changes, maximal canal and cord compression, white (WM) and gray matter (GM) atrophy, and microstructural indices from diffusion-weighted scans. All patients underwent clinical (modified Japanese Orthopaedic Association; mJOA) and electrophysiological assessments. Regression analysis assessed associations between magnetic resonance imaging (MRI) readouts and electrophysiological and clinical outcomes. Twenty patients were classified with mild and 4 with moderate DCM using the mJOA scale. The most frequent site of compression was at the C5\u2013C6 level, with maximum cord compression of 38.73%\u2009\u00b1\u200911.57%. Ten patients showed imaging evidence of cervical myelopathy. In the cervical cord, WM and GM atrophy and WM microstructural changes were evident, whereas in the lumbar cord only WM showed atrophy and microstructural changes. Remote cervical cord WM microstructural changes were pronounced in patients with radiological myelopathy and associated with impaired electrophysiology. Lumbar cord WM atrophy was associated with lower limb sensory impairments. In conclusion, tissue-specific neurodegeneration revealed by quantitative MRI is already apparent across the spinal cord in mild-moderate DCM before the onset of severe clinical impairments. WM microstructural changes are particularly sensitive to remote pathologically and clinically eloquent changes in DCM.<\/jats:p>","DOI":"10.1089\/neu.2021.0148","type":"journal-article","created":{"date-parts":[[2021,7,9]],"date-time":"2021-07-09T04:13:05Z","timestamp":1625803985000},"page":"2978-2987","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":41,"title":["Tracking White and Gray Matter Degeneration along the Spinal Cord Axis in Degenerative Cervical Myelopathy"],"prefix":"10.1177","volume":"38","author":[{"given":"Kevin","family":"Vallotton","sequence":"first","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gergely","family":"David","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus","family":"Hupp","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolai","family":"Pfender","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Cohen-Adad","sequence":"additional","affiliation":[{"name":"NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montreal, Montreal, Quebec, Canada."},{"name":"Functional Neuroimaging Unit, CRIUGM, University of Montreal, Montreal, Quebec, Canada."},{"name":"Mila\u2013Quebec AI Institute, Montreal, Quebec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Fehlings","sequence":"additional","affiliation":[{"name":"Department of Surgery and Spine Program, University of Toronto and Toronto Western Hospital, Toronto, Ontario, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca S.","family":"Samson","sequence":"additional","affiliation":[{"name":"NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia A.M. Gandini","family":"Wheeler-Kingshott","sequence":"additional","affiliation":[{"name":"NMR Research Unit, Queen Square MS Centre, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, London, United Kingdom."},{"name":"Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy."},{"name":"Brain Connectivity Centre, IRCCS Mondino Foundation, Pavia, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Armin","family":"Curt","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Freund","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."},{"name":"Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany."},{"name":"Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, United Kingdom."},{"name":"Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, London, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryam","family":"Seif","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Center Balgrist, University of Zurich, Zurich, Switzerland."},{"name":"Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,14]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0000000000000913"},{"key":"e_1_3_4_3_2","first-page":"69","article-title":"Cervical spondylotic myelopathy: what the neurologist should know","volume":"8","author":"de Oliveira Vila\u00e7a C.","year":"2016","unstructured":"de Oliveira Vila\u00e7a C., , Orsini M., , Leite M.A.A., , de Freitas M.R.G., , Davidovich E., , Fiorelli R., , Fiorelli S., , Fiorelli C., , Oliveira A.B., , and Pessoa B.L. 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