Zheng Jiangqin, Zhang Yujin, Zhao Baogen, Wang Ning, Gao Ting, Zhang Li
Department of Radiology, Hainan Maternal and Child Health Centre, Haikou, China.
Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China.
Front Neurol. 2025 Jan 8;15:1513896. doi: 10.3389/fneur.2024.1513896. eCollection 2024.
To assess the changes of thalamic metabolites before and after surgery in patients with Cervical Spondylotic Myelopathy (CSM) using Hydrogen Proton Magnetic Resonance Spectroscopy (H-MRS) and to investigate its association with improvement in neurological function.
Forty-eight CSM patients who underwent cervical decompression surgery from December 2022 to June 2023 were included, and 33 healthy volunteers were recruited. All subjects underwent bilateral thalamic H-MRS scans before the surgical procedure, and subsequently again 6 months later. Neurological function was assessed pre-operatively and post-operatively (6 months) in all patients with CSM using the modified Japanese Orthopedic Association (mJOA). The changes of mJOA (ΔmJOA = postoperative mJOA-preoperative mJOA) were employed as an indicator of neurological improvement. The pre- and postoperative metabolic ratio of -acetylaspartate/creatine (NAA/Cr), choline/creatine (Cho/Cr), myo-inositol/creatine (mI/Cr), glutamate and glutamine complex/creatine (Glx/Cr) were statistically compared in CSM patients and healthy controls (HCs). A correlation analysis was conducted to determine the relationship between alterations in pre- and postoperative metabolite ratios (ΔNAA/Cr, ΔCho/Cr, ΔmI/Cr, ΔGlx/Cr) and ΔmJOA.
Compared to the HCs, patients with CSM showed significantly lower pre- and post-operative NAA/Cr ( = -4.235, < 0.001; = -3.184, = 0.001), Cho/Cr ( = -5.050, < 0.001; ( = -2.624, = 0.007) and mI/Cr ( = -3.739, = 0.001; = -2.014, = 0.044). There was no difference in Glx/Cr between patients in patients with CSM, either preoperatively or postoperatively, compared to HCs. Post-operative NAA/Cr ( = -2.285, = 0.041) and mI/Cr ( = -2.925, = 0.021) were increased in CSM patients compared to pre-operative NAA/Cr and mI/Cr. In CSM patients, ΔmI/Cr correlated significantly with ΔmJOA ( = 0.507, < 0.001).
The preliminary findings indicate that metabolites in the thalamus of CSM patients exhibit changes following surgery. Additionally, it has been demonstrated that elevated postoperative mI correlates with improvements in neurological function.
采用氢质子磁共振波谱（H-MRS）评估脊髓型颈椎病（CSM）患者手术前后丘脑代谢物的变化，并探讨其与神经功能改善的关系。
纳入2022年12月至2023年6月接受颈椎减压手术的48例CSM患者，并招募33名健康志愿者。所有受试者在手术前进行双侧丘脑H-MRS扫描，6个月后再次扫描。所有CSM患者在术前和术后（6个月）使用改良日本骨科学会（mJOA）评分评估神经功能。mJOA评分的变化（ΔmJOA = 术后mJOA评分 - 术前mJOA评分）作为神经功能改善的指标。对CSM患者和健康对照（HCs）术前和术后的N-乙酰天门冬氨酸/肌酸（NAA/Cr）、胆碱/肌酸（Cho/Cr）、肌醇/肌酸（mI/Cr）、谷氨酸和谷氨酰胺复合物/肌酸（Glx/Cr）代谢比值进行统计学比较。进行相关性分析以确定术前和术后代谢物比值变化（ΔNAA/Cr、ΔCho/Cr、ΔmI/Cr、ΔGlx/Cr）与ΔmJOA之间的关系。
与HCs相比，CSM患者术前和术后的NAA/Cr（t = -4.235，P < 0.001；t = -3.184，P = 0.001）、Cho/Cr（t = -5.050，P < 0.001；t = -2.624，P = 0.007）和mI/Cr（t = -3.739，P = 0.001；t = -2.014，P = 0.044）均显著降低。与HCs相比，CSM患者术前和术后的Glx/Cr无差异。与术前的NAA/Cr和mI/Cr相比，CSM患者术后的NAA/Cr（t = -2.285，P = 0.041）和mI/Cr（t = -2.925，P = 0.021）升高。在CSM患者中，ΔmI/Cr与ΔmJOA显著相关（r = 0.507，P < 0.001）。
初步研究结果表明，CSM患者丘脑代谢物在手术后出现变化。此外，已证明术后mI升高与神经功能改善相关。
