Changes in thalamic metabolites correlate with severity of spinal cord injury based on diffusion tensor imaging in...

To investigate the changes in thalamic metabolites in patients with cervical spondylotic myelopathy (CSM) using magnetic resonance spectroscopy (MRS) and their correlation with the severity of spinal cord injury based on diffusion tensor imaging (DTI).

A total of 93 CSM patients and 67 healthy controls (HCs) were enrolled in this prospective study from December 2023 to September 2024. All participants underwent routine magnetic resonance imaging (MRI) of the cervical spine, MRS of the bilateral thalamus, and DTI of cervical spine. Parameters of DTI (FA, ADC) and MRS (NAA/Cr, Cho/Cr, MI/Cr, and Glx/Cr) were compared between the CSM patients and HCs. Correlation analyses were performed among clinical characteristics, MRI features of cervical spine, and DTI and MRS parameters in CSM patients. Multivariate linear regression equations for thalamic metabolites were established based on these features.

FA values in the CSM group were significantly lower than those in the HCs (p = 0.005, t = 2.874). The CSM group exhibited significantly reduced NAA/Cr (p < 0.001, Z = -5.922), Cho/Cr (p < 0.001, Z = -6.857), and MI/Cr ratios (p < 0.001, Z = -5.922) compared to the HCs. In the CSM group, NAA/Cr (r = 0.444, p < 0.001), Cho/Cr (r = 0.308, p = 0.003), and MI/Cr (r = -0.489, p < 0.001) correlated with FA values. NAA/Cr also correlated with symptom duration (r = -0.365, p < 0.001). The multivariate linear regression equations for thalamic metabolites were as follows: NAA/Cr = 0.833 + 1.520*FA-0.007*duration; Cho/Cr = 0.209 + 0.774*FA; MI/Cr = 1.566-1.722*FA + 0.008*mJOA scores; Glx/Cr = 0.942 + 0.009*duration.

CSM patients exhibit metabolic alterations in the dorsal thalamus, which are linearly correlated with the severity of spinal cord injury.