Tract-Specific Diffusion Tensor Imaging Reveals Laterality of Neurological Symptoms in Patients with Cervical Compression Myelopathy

Satoshi Maki, Masao Koda, Junya Saito, Sho Takahashi, Taigo Inada, Koshiro Kamiya, Mitsutoshi Ota, Yasushi Iijima, Yoshitada Masuda, Koji Matsumoto, Masatoshi Kojima, Kazuhisa Takahashi, Takayuki Obata, Masashi Yamazaki, Takeo Furuya

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Background Patients with cervical compression myelopathy (CCM) generally present bilateral neurological symptoms in their extremities. However, a substantial portion of patients with CCM exhibit laterality of neurological symptoms. The aim of this study was to assess the correlation between intrinsic structural damage and laterality of symptoms using spinal cord diffusion tensor imaging (DTI) of the corticospinal tract. Methods We enrolled 10 healthy volunteers and 40 patients with CCM in this study. We evaluated motor function using the American Spinal Injury Association (ASIA) motor score for left and right extremities. For DTI acquisitions, a 3.0-T magnetic resonance imaging system with diffusion-weighted spin-echo sequence was used. Regions-of-interest in the lateral column tracts were determined. We determined the correlations between fractional anisotropy (FA) and ASIA motor scores. An FA asymmetry index was calculated using left and right regions-of-interest. Results Four patients exhibited laterality of symptoms in their extremities, for which left and right ASIA scores correlated moderately with FA in the left and right lateral columns, respectively (left: ρ = 0.64, P < 0.001; right: ρ = 0.67, P < 0.001). The area under the receiver-operator characteristic curve showed that the FA asymmetry index indicated laterality of symptoms. Conclusions Using tract-specific DTI, we demonstrated that microstructural damages in the left and right corticospinal tracts correlated with corresponding neurological symptoms in the ipsilateral side and the FA asymmetry index could indicate laterality in neurological symptoms of patients with CCM.

Original languageEnglish
Pages (from-to)184-190
Number of pages7
JournalWorld Neurosurgery
Volume96
DOIs
Publication statusPublished - 1 Dec 2016
Externally publishedYes

Keywords

  • Asymmetry index
  • Cervical compression myelopathy
  • Diffusion tensor imaging
  • Laterality
  • Spinal cord

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