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We aimed to assess the value of contact heat evoked potentials (CHEPs) in addition to MRI and hypothesized that abnormal CHEPs may be evident in DCM independent of MR\u2010lesions and are related to dynamic mechanical cord stress.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Individuals with DCM underwent neurologic examination including segmental sensory (pinprick, light touch) and motor testing. The presence or absence of hyperintense signal on T2\u2010weighted MRI (T2\u2010positive\/negative) was assessed. Phase\u2010contrast MRI was used to assess spinal cord motion as an indicator of dynamic mechanical stress. Dermatomal somatosensory evoked potentials and CHEPs were recorded after stimulation of dermatomes C6, C8, and T4 (CHEPs only) to assess spinal cord integrity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 138 individuals included in this study (age 56\u2009\u00b1\u200913\u2009years), 35% (<jats:italic>N<\/jats:italic>\u2009=\u200948) presented with T2\u2010positive and 65% (<jats:italic>N<\/jats:italic>\u2009=\u200990) presented with T2\u2010negative DCM. Abnormal CHEPs were present in T2\u2010positive DCM (C6:41%; C8:32%; T4:24%) and T2\u2010negative DCM (C6:35%; C8:54%; T4:26%). Multisegmental CHEP abnormalities at C6 and C8 were related to increased spinal cord motion (<jats:italic>p<\/jats:italic>\u2009=\u20090.030; \u03f5<jats:sup>2<\/jats:sup>\u2009=\u20090.072), and reduced upper extremity pinprick (<jats:italic>p<\/jats:italic>\u2009=\u20090.046; \u03f5<jats:sup>2<\/jats:sup>\u2009=\u20090.063) and motor scores (<jats:italic>p<\/jats:italic>\u2009=\u20090.005; \u03f5<jats:sup>2<\/jats:sup>\u2009=\u20090.108).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>CHEPs revealed distinct patterns of spinal cord impairment independent of structural T2\u2010positive lesions, which were associated with measures of cord motion. CHEPs thus provide valuable complementary diagnostic insights into spinal cord integrity beyond MRI. This is especially important in incipient myelopathy to inform early diagnosis and timely interventions before the development of definite cord lesions.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.70001","type":"journal-article","created":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T09:00:11Z","timestamp":1734771611000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Contact heat evoked potentials reveal distinct patterns of spinal cord impairment in degenerative cervical myelopathy beyond <scp>MRI<\/scp> lesions"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7568-0133","authenticated-orcid":false,"given":"Paulina Simonne","family":"Scheuren","sequence":"first","affiliation":[{"name":"Spinal Cord Injury Center, Balgrist University Hospital University of Zurich  Zurich Switzerland"},{"name":"Department of Neurology, University Hospital Bern, Inselspital University of 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