Diagnostic value of cervical spine ZOOM-DWI in cervical spondylotic myelopathy

PURPOSE

To investigate the clinical application value of the non-shared incentive diffusion imaging technique (ZOOM-DWI) diagnoses of cervical spondylotic myelopathy (CSM).

METHODS

49 CSM patients who presented from January 2022 to December 2022 were selected as the patient group, and 50 healthy volunteers are recruited as the control group. All subjects underwent conventional MRI and ZOOM-DWI of the cervical spine and neurologic mJOA scores in patients with CSM. The spinal ADC values of segments C2-3, C4-5, C5-6, and C6-7 are measured and analyzed in all subjects, with C5-6 being the most severe level of spinal canal compression in the patient group. In addition, the study also analyzes and compares the relationship between the C5-6 ADC value and mJOA score in the patient group.

RESULTS

The mean ADC shows no significantly different levels in the control group. Among the ADC values at each measurement level in the patient group, except for C4-5 and C6-7 segments are not statistically significant, the remaining pair-wise comparisons all show statistically significant differences (F = 24.368, p < 0.001). And these individuals have the highest ADC value at C5-6. The C5-6 ADC value in the patient group is significantly higher compared with the ADC value in the control group (t = 9.414, p < 0.001), with statistical significance. The ADC value at the patient stenosis shows a significant negative correlation with the mJOA score (r = -0.493, p < 0.001).

CONCLUSION

Cervical ZOOM-DWI can be applied to diagnose CSM, and spinal ADC value can use as reliable imaging data for diagnosing cervical myelopathy.

The tracts, cytoarchitecture, and neurochemistry of the spinal cord

The human spinal cord can be described using a range of nomenclatures with each providing insight into its structure and function. Here we have comprehensively reviewed the key literature detailing the general structure, configuration of tracts, the cytoarchitecture of Rexed's laminae, and the neurochemistry at the spinal segmental level. The purpose of this review is to detail current anatomical understanding of how the spinal cord is structured and to aid researchers in identifying gaps in the literature that need to be studied to improve our knowledge of the spinal cord which in turn will improve the potential of therapeutic intervention for disorders of the spinal cord.

Role of Sensory Pathway Injury in Central Post-Stroke Pain: A Narrative Review of Its Pathogenetic Mechanism

Central post-stroke pain (CPSP) is a severe chronic neuropathic pain syndrome that is a direct result of cerebrovascular lesions affecting the central somatosensory system. The pathogenesis of this condition remains unclear owing to its extensive clinical manifestations. Nevertheless, clinical and animal experiments have allowed a comprehensive understanding of the mechanisms underlying CPSP occurrence, based on which different theoretical hypotheses have been proposed. We reviewed and collected the literature and on the mechanisms of CPSP by searching the English literature in PubMed and EMBASE databases for the period 2002-2022. Recent studies have reported that CPSP occurrence is mainly due to post-stroke nerve injury and microglial activation, with an inflammatory response leading to central sensitization and de-inhibition. In addition to the primary injury at the stroke site, peripheral nerves, spinal cord, and brain regions outside the stroke site are involved in the occurrence and development of CPSP. In the present study, we reviewed the mechanism of action of CPSP from both clinical studies and basic research based on its sensory pathway. Through this review, we hope to increase the understanding of the mechanism of CPSP.

Relation Between the Corticospinal Tract State and Activities of Daily Living in Patients With Intracerebral Hemorrhage

Supplemental Digital Content is available in the text.

Background and Purpose:

We investigated the relation between the ipsilesional corticospinal tract (CST) state and activity of daily living independence in patients with chronic intracerebral hemorrhage.

Methods:

Fifty-six consecutive patients with unilateral intracerebral hemorrhage and 38 healthy control subjects were recruited for this study. The Motricity index and the modified Barthel index were used to evaluate motor function of the affected extremities and activity of daily living independence, respectively. The diffusion tensor imaging parameter values for fractional anisotropy (FA) and voxel number (VN) of the CST were determined. Ratios of the ipsilesional to the contralesional CST measures were calculated and are presented as the CST-ratio (FA value and VN).

Results:

The FA value and VN of the ipsilesional CST and the CST-ratio in the patient group were lower than those of the control group (P<0.05). There was a strong positive correlation between the Motricity index score of the affected extremities and the modified Barthel index score (P<0.05), while the FA value and VN of the ipsilesional CST and the CST-ratio showed moderate and strong positive correlations with the Motricity index and modified Barthel index scores, respectively (P<0.05). In addition, the VN of the ipsilesional CST showed excellent utility as a classifier, whereas the FA value of the ipsilesional CST and the FA value and VN of the CST-ratio showed good classifier utility (P<0.05).

Conclusions:

We demonstrated that impairment of activity of daily living independency was closely related to the injury severity of the ipsilesional CST in patients with chronic intracerebral hemorrhage. In addition, the injury severity of the ipsilesional CST can be used to classify the degree of activity of daily living independency.

Registration:

URL: http://www.e-irb.com/index.jsp; Unique identifier: 2021-03-014.

Reconstruction of the corticorubral tract in the human brain using diffusion tensor tractography

The corticorubral tract (CRT) facilitates fine motor coordination. However, no diffusion tensor tractography (DTT) study has been conducted although a few studies have reported on the cortical connection of the red nucleus. In this study, we investigated the DTT reconstruction method and DTT characteristics of the CRT in normal subjects. Thirty-six right-handed normal subjects were recruited. Diffusion tensor images were scanned using a 1.5 T MRI scanner. For analysis of the CRT, the seed region of interest (ROI) was placed on the red nucleus of the midbrain, and the target ROI was placed on the primary sensorimotor cortex. Values of fractional anisotropy (FA), mean diffusivity (MD), and tract volume (TV) of the CRT were obtained for both hemispheres. Among the 72 cerebral hemispheres of the 36 normal subjects, the neural tract between the red nucleus and the primary sensorimotor cortex was reconstructed in 66 hemispheres (92%). The reconstructed CRT, which originated from the primary sensorimotor cortex, descended through the posterior portion of the centrum semiovale, the corona radiata and posterior limb of the internal capsule, and terminated at the red nucleus. Analysis of the FA, MD, and TV values revealed no significant differences between the right and left hemispheres (p > 0.05). We describe the method of DTT reconstruction and the imaging parameters of the CRT in the brain of normal subjects. We believe that the DTT method and associated parameter results for the CRT in normal subjects will be useful in future neuroscience studies.