{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,9]],"date-time":"2026-11-09T16:52:05Z","timestamp":1794243125186,"version":"4.9.0"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2017,11,18]],"date-time":"2017-11-18T00:00:00Z","timestamp":1510963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["NEUROSURGERY","NEUROS"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>In degenerative cervical myelopathy (DCM), the dynamics of disease progression and the outcome after surgical decompression vary interindividually and do not necessarily correlate with radiological findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>To improve diagnostic power in DCM by better characterization of the underlying pathophysiology using navigated transcranial magnetic stimulation (nTMS).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>Eighteen patients with DCM due to cervical spinal canal stenosis were examined preoperatively with nTMS. On the basis of the initial Japanese Orthopedic Association (JOA) Score, 2 patient groups were established (JOA \u226412\/&gt;12). We determined the resting motor threshold, recruitment curve, cortical silent period, and motor area. Accordingly, 8 healthy subjects were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Although the resting motor threshold was comparable in both groups (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0= .578), the corticospinal excitability estimated by the recruitment curve was reduced in patients (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0= .022). In patients with only mild symptoms (JOA &gt;\u00a012), a compensatory higher activation of non-primary motor areas was detected (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt; .005). In contrast, patients with severe impairment (JOA \u2264\u00a012) showed a higher cortical inhibition (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt; .05) and reduced cortical motor area (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u00a0&lt; .05) revealing a functional restriction on the cortical level.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Based on these results, we propose a new concept for functional compensation for DCM on the cortical and spinal level, ie corticospinal reserve capacity. nTMS is a useful tool to noninvasively characterize the pattern of functional impairment and compensatory reorganization in patients suffering from DCM. The change in nTMS parameters might serve as a valuable prognostic factor in these patients in the future.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuros\/nyx437","type":"journal-article","created":{"date-parts":[[2017,8,9]],"date-time":"2017-08-09T15:12:50Z","timestamp":1502291570000},"page":"810-818","source":"Crossref","is-referenced-by-count":60,"title":["The Corticospinal Reserve Capacity: Reorganization of Motor Area and Excitability As a Novel Pathophysiological Concept in Cervical Myelopathy"],"prefix":"10.1227","volume":"83","author":[{"given":"Anna","family":"Zdunczyk","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Ger-many"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Schwarzer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Ger-many"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Mikhailov","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Ger-many"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendon","family":"Bagley","sequence":"additional","affiliation":[{"name":"Department of Radiology, Univer-sity of California San Diego, San Diego, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tizian","family":"Rosenstock","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Ger-many"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Picht","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Ger-many"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Vajkoczy","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Charit\u00e9 Universit\u00e4tsmedizin Berlin, Berlin, Ger-many"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,10]]},"reference":[{"issue":"12","key":"bib1-20231011","doi-asserted-by":"crossref","first-page":"E675","DOI":"10.1097\/BRS.0000000000000913","article-title":"Degenerative cervical myelopathy: epidemiology, genetics, and pathogenesis","volume":"40","author":"Nouri","year":"2015","journal-title":"Spine (Phila Pa 1976)"},{"issue":"suppl 2)","key":"bib2-20231011","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1007\/s00586-014-3264-4","article-title":"Pathobiology of cervical spondylotic myelopathy","volume":"24","author":"Karadimas","year":"2015","journal-title":"Eur Spine J"},{"issue":"22","key":"bib3-20231011","doi-asserted-by":"crossref","first-page":"7528","DOI":"10.1523\/JNEUROSCI.0379-10.2010","article-title":"Spinal cord injury immediately changes the state of the brain","volume":"30","author":"Aguilar","year":"2010","journal-title":"J Neurosci"},{"issue":"pt 6","key":"bib4-20231011","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1093\/brain\/awr093","article-title":"Disability, atrophy and cortical reorganization following spinal cord injury","volume":"134","author":"Freund","year":"2011","journal-title":"Brain"},{"issue":"6","key":"bib5-20231011","doi-asserted-by":"crossref","first-page":"527","DOI":"10.1177\/1545968307301872","article-title":"Sensorimotor cortical plasticity during recovery following spinal cord injury: a longitudinal fMRI study","volume":"21","author":"Jurkiewicz","year":"2007","journal-title":"Neurorehabil Neural Repair"},{"issue":"3","key":"bib6-20231011","doi-asserted-by":"crossref","first-page":"E863","DOI":"10.1227\/01.NEU.0000374848.86299.17","article-title":"Changes in functional magnetic resonance imaging cortical activation after decompression of cervical spondylosis: case report","volume":"67","author":"Tam","year":"2010","journal-title":"Neurosurgery"},{"issue":"3","key":"bib7-20231011","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1227\/NEU.0b013e3182181b89","article-title":"Preoperative functional mapping for rolandic brain tumor surgery: comparison of navigated transcranial magnetic stimulation to direct cortical stimulation","volume":"69","author":"Picht","year":"2011","journal-title":"Neurosurgery"},{"issue":"(1)","key":"bib8-20231011","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1212\/WNL.0000000000002802","article-title":"Motor plasticity after extra-intracranial bypass surgery in occlusive cerebrovascular disease","volume":"87","author":"Jussen","year":"2016","journal-title":"Neurology."},{"issue":"4","key":"bib9-20231011","doi-asserted-by":"crossref","first-page":"e0123022","DOI":"10.1371\/journal.pone.0123022","article-title":"Comparison of the Japanese Orthopaedic Association (JOA) score and modified JOA (mJOA) score for the assessment of cervical myelopathy: a multicenter observational study","volume":"10","author":"Kato","year":"2015","journal-title":"PLoS One"},{"issue":"12","key":"bib10-20231011","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1007\/s00586-007-0512-x","article-title":"Analysis of five specific scores for cervical spondylogenic myelopathy","volume":"16","author":"Vitzthum","year":"2007","journal-title":"Eur Spine J"},{"issue":"1","key":"bib11-20231011","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.jneumeth.2007.12.005","article-title":"Factors influencing cortical silent period: optimized stimulus location, intensity and muscle contraction","volume":"169","author":"Saisanen","year":"2008","journal-title":"J Neurosci Methods"},{"key":"bib12-20231011","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1016\/j.jneumeth.2014.05.020","article-title":"Methods for estimating cortical motor representation size and location in navigated transcranial magnetic stimulation","volume":"232","author":"Julkunen","year":"2014","journal-title":"J Neurosci Methods"},{"issue":"8","key":"bib13-20231011","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1084\/jem.20040452","article-title":"Remodeling of axonal connections contributes to recovery in an animal model of multiple sclerosis","volume":"200","author":"Kerschensteiner","year":"2004","journal-title":"J Exp Med"},{"issue":"8","key":"bib14-20231011","doi-asserted-by":"crossref","first-page":"1717","DOI":"10.1016\/j.clinph.2004.03.006","article-title":"TMS and drugs","volume":"115","author":"Ziemann","year":"2004","journal-title":"Clin Neurophysiol"},{"issue":"1","key":"bib15-20231011","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/S1388-2457(03)00320-1","article-title":"Direct recording of the output of the motor cortex produced by transcranial magnetic stimulation in a patient with cerebral cortex atrophy","volume":"115","author":"Di Lazzaro","year":"2004","journal-title":"Clin Neurophysiol"},{"issue":"(1)","key":"bib16-20231011","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1152\/jn.1996.75.1.248","article-title":"Structural and functional alterations in rat cortico spinal neurons after axotomy","volume":"75","author":"Tseng","year":"1996","journal-title":"J Neurophysiol."},{"issue":"(6)","key":"bib17-20231011","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S1388-2457(01)00533-8","article-title":"Mechanism of prolonged central motor conduction time in compressive cervical myelopathy","volume":"112","author":"Kaneko","year":"2001","journal-title":"Clin Neurophysiol."},{"issue":"3","key":"bib18-20231011","doi-asserted-by":"crossref","first-page":"623","DOI":"10.1016\/j.clinph.2005.11.010","article-title":"Corticospinal tract conduction block results in the prolongation of central motor conduction time in compressive cervical myelopathy","volume":"117","author":"Nakanishi","year":"2006","journal-title":"Clin Neurophysiol"},{"issue":"(5)","key":"bib19-20231011","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1016\/0168-5597(92)90107-M","article-title":"The contribution of magnetic stimulation of the motor cortex to the diagnosis of cervical spondylotic myelopathy. Correlation of central motor conduction to distal and proximal upper limb muscles with clinical and MRI findings","volume":"85","author":"Di Lazzaro","year":"1992","journal-title":"Electroencephalogr Clin Neurophysiol."},{"issue":"1","key":"bib20-20231011","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s00586-012-2554-y","article-title":"Evaluation of corticospinal excitability in cervical myelopathy, before and after surgery, with transcranial magnetic stimulation: a pilot study","volume":"22","author":"Nicotra","year":"2013","journal-title":"Eur Spine J"},{"issue":"1","key":"bib21-20231011","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s00221-002-1234-2","article-title":"Transcranial magnetic stimulation: new insights into representational cortical plasticity","volume":"148","author":"Siebner","year":"2003","journal-title":"Exp Brain Res"},{"issue":"pt 3","key":"bib22-20231011","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1093\/brain\/awl002","article-title":"Motor system activation after subcortical stroke depends on corticospinal system integrity","volume":"129","author":"Ward","year":"2006","journal-title":"Brain"},{"issue":"(20)","key":"bib23-20231011","doi-asserted-by":"crossref","first-page":"8098","DOI":"10.1073\/pnas.86.20.8098","article-title":"Convergence and divergence of neurotransmitter action in human cerebral cortex","volume":"86","author":"McCormick","year":"1989","journal-title":"Proc Natl Acad Sci USA."},{"key":"bib24-20231011","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1113\/jphysiol.1993.sp019732","article-title":"Silent period evoked by transcranial stimulation of the human cortex and cervicomedullary junction","volume":"466","author":"Inghilleri","year":"1993","journal-title":"J Physiol"},{"issue":"(pt 2)","key":"bib25-20231011","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/j.1469-7793.1999.0591t.x","article-title":"Differential effects on motor cortical inhibition induced by blockade of GABA uptake in humans","volume":"517","author":"Werhahn","year":"1999","journal-title":"J Physiol."},{"issue":"3","key":"bib26-20231011","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1002\/cne.10733","article-title":"Primary cortical motor neurons undergo apoptosis after axotomizing spinal cord injury","volume":"462","author":"Hains","year":"2003","journal-title":"J Comp Neurol"},{"issue":"(6)","key":"bib27-20231011","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1016\/S1388-2457(02)00062-7","article-title":"Motor disinhibition in affected and unaffected hemisphere in the early period of recovery after stroke","volume":"113","author":"Manganotti","year":"2002","journal-title":"Clin Neurophysiol."},{"issue":"4","key":"bib28-20231011","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.brs.2016.01.003","article-title":"Cortical damage and disability in multiple sclerosis: relation to intracortical inhibition and facilitation.","volume":"9","author":"Nantes","year":"2016","journal-title":"Brain Stimul"},{"issue":"39","key":"bib29-20231011","doi-asserted-by":"crossref","first-page":"12210","DOI":"10.1523\/JNEUROSCI.1828-09.2009","article-title":"Functional and anatomical reorganization of the sensory-motor cortex after incomplete spinal cord injury in adult rats","volume":"29","author":"Ghosh","year":"2009","journal-title":"J Neurosci"},{"issue":"2","key":"bib30-20231011","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1016\/j.expneurol.2007.06.014","article-title":"Cortical and subcortical plasticity in the brains of humans, primates, and rats after damage to sensory afferents in the dorsal columns of the spinal cord","volume":"209","author":"Kaas","year":"2008","journal-title":"Exp Neurol"},{"issue":"23","key":"bib31-20231011","doi-asserted-by":"crossref","first-page":"7549","DOI":"10.1523\/JNEUROSCI.2474-08.2009","article-title":"Exercise induces cortical plasticity after neonatal spinal cord injury in the rat","volume":"29","author":"Kao","year":"2009","journal-title":"J Neurosci"},{"issue":"(2)","key":"bib32-20231011","first-page":"97","article-title":"Topka H Combination of TMS and fMRI reveals a specific pattern of reorganization in M1","volume":"24","author":"Lotze","year":"2006","journal-title":"Restor Neurol Neurosci."},{"issue":"2","key":"bib33-20231011","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1177\/1545968309347680","article-title":"Sensorimotor cortical activation in patients with cervical spinal cord injury with persisting paralysis","volume":"24","author":"Jurkiewicz","year":"2010","journal-title":"Neurorehabil Neural Repair"},{"issue":"37","key":"bib34-20231011","doi-asserted-by":"crossref","first-page":"12267","DOI":"10.1523\/JNEUROSCI.1593-14.2014","article-title":"Corticospinal sprouting differs according to spinal injury location and cortical origin in macaque monkeys","volume":"34","author":"Darian-Smith","year":"2014","journal-title":"J Neurosci"},{"issue":"(13)","key":"bib35-20231011","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1212\/WNL.0b013e3181d6b0ea","article-title":"Brain reorganization in patients with spinal cord compression evaluated using fMRI","volume":"74","author":"Duggal","year":"2010","journal-title":"Neurology"},{"issue":"(pt 3)","key":"bib36-20231011","doi-asserted-by":"crossref","first-page":"595","DOI":"10.1093\/brain\/awf047","article-title":"Variability of cerebral blood volume and oxygen extraction stages of cerebral haemodynamic impairment revisited","volume":"125","author":"Derdeyn","year":"2002","journal-title":"Brain"}],"container-title":["Neurosurgery"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/neurosurgery\/article-pdf\/83\/4\/810\/32600290\/nyx437.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ovid.com\/00006123-201810000-00025","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:50:24Z","timestamp":1786121424000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/00006123-201810000-00025"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,18]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2018]]}},"URL":"https:\/\/doi.org\/10.1093\/neuros\/nyx437","relation":{},"ISSN":["0148-396X","1524-4040"],"issn-type":[{"value":"0148-396X","type":"print"},{"value":"1524-4040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,18]]}}}