Changes to Dorsal Thalamic Metabolites and Thalamocortical Tract Fiber Injury in Patients with Cervical Spondylotic Myelopathy.

Purpose: This study aims to assess thalamocortical tract fiber injury using diffusion-tensor imaging (DTI) and to characterize metabolic alterations in the dorsal thalamus with proton magnetic resonance spectroscopy (MRS) in patients with cervical spondylotic myelopathy (CSM).

Methods: A prospective study involved 98 CSM patients and 66 age-matched controls without neurological disease, recruited from May 2021 to December 2021. Neurological function was evaluated using the modified Japanese Orthopaedic Association (mJOA) score. DTI and MRS were analyzed by 2 experienced radiologists, with statistical analysis performed via SPSS (v.26), including t-tests, chi-square tests, and Pearson's correlation.

Results: DTI revealed significantly lower fractional anisotropy (FA) and higher radial and axial diffusivity in the bilateral postcentral gyrus of CSM patients compared to controls (P < 0.001). MRS showed decreased ratios of N-acetylaspartate (NAA)/creatinine (Cr), choline (Cho)/Cr, and myo-inositol (mI)/Cr in the dorsal thalamus of CSM patients (P < 0.001). Correlation analysis indicated a moderate association between mJOA scores and NAA/Cr and mI/Cr ratios, and a weaker correlation with FA and Cho/Cr.

Conclusion: CSM patients exhibit significant thalamocortical disruptions and metabolic changes in the dorsal thalamus, correlating with clinical severity. These findings suggest that DTI and MRS could provide valuable insights into the extent of neural damage in CSM.