• 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, and Takeo Furuya.
• Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba City, Chiba, Japan. Electronic address: makisatoshi@hotmail.com.
• World Neurosurg. 2016 Dec 1; 96: 184-190.

BackgroundPatients 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.MethodsWe 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.ResultsFour 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.ConclusionsUsing 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.Copyright © 2016 Elsevier Inc. All rights reserved.

28 keywords...

hide…