Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Quantitative MR Markers in Non-Myelopathic Spinal Cord Compression: A Narrative Review

Version 1 : Received: 25 February 2022 / Approved: 28 February 2022 / Online: 28 February 2022 (10:20:37 CET)

A peer-reviewed article of this Preprint also exists.

Valošek, J.; Bednařík, P.; Keřkovský, M.; Hluštík, P.; Bednařík, J.; Svátková, A. Quantitative MR Markers in Non-Myelopathic Spinal Cord Compression: A Narrative Review. J. Clin. Med. 2022, 11, 2301. Valošek, J.; Bednařík, P.; Keřkovský, M.; Hluštík, P.; Bednařík, J.; Svátková, A. Quantitative MR Markers in Non-Myelopathic Spinal Cord Compression: A Narrative Review. J. Clin. Med. 2022, 11, 2301.

Abstract

Degenerative spinal cord (SC) compression is a frequent pathological condition with increasing prevalence throughout aging. Initial non-myelopathic cervical SC compression (NMDC) might progress over time into potentially irreversible degenerative cervical myelopathy (DCM). While quantitative MRI (qMRI) techniques demonstrated the ability to depict intrinsic tissue properties, longitudinal in-vivo biomarkers to identify NMDC patients who will eventually develop DCM are still missing. Thus, we aim to review the ability of qMRI techniques (such as diffusion MRI, diffusion tensor imaging (DTI), magnetization transfer (MT) imaging, magnetic resonance spec-troscopy (1H-MRS)) to serve as prognostic markers in NMDC. While DTI in NMDC patients con-sistently detected lower fractional anisotropy and higher mean diffusivity at compressed levels caused by demyelination and axonal injury, MT and 1H-MRS along with advanced and tract-specific diffusion MRI recently revealed microstructural alterations also rostrally pointing to Wallerian degeneration. Recent studies also disclosed significant relationship between micro-structural damage and functional deficits, assessed by qMRI and electrophysiology, respectively. Thus, tract-specific qMRI in combination with electrophysiology critically extend our under-standing of the underlying pathophysiology of degenerative SC compression and may provide predictive markers of DCM development for accurate patient management. However, the prog-nostic value must be validated in longitudinal studies.

Keywords

non-myelopathic cervical spinal cord compression; degenerative cervical myelopathy; diffusion magnetic resonance imaging; quantitative magnetic resonance imaging

Subject

Medicine and Pharmacology, Neuroscience and Neurology

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