RESUMO
PURPOSE: Degenerative cervical myelopathy (DCM) is a common cause of spinal cord dysfunction. In this study, we explored the potential of magnetization transfer ratio (MTR) for evaluating the structural integrity of spinal cord tracts in patients with clinically significant DCM. METHODS: Fifty-three patients with DCM and 41 patients with cervical radiculopathy were evaluated using high-resolution cervical spinal cord magnetic resonance imaging (MRI), which included the magnetization transfer technique. MRI data were analyzed with the Spinal Cord Toolbox (v5.5); MTR values in each spinal tract were calculated and compared between groups after correction for patient age and sex. Correlations between MTR values and patients' clinical disability rate were also evaluated. RESULTS: A statistically significant reduction in the average MTR of the spinal cord white matter, as well as the MTR of the ventral columns and lateral funiculi, was revealed in the DCM group (adjusted p < 0.01 for all comparisons). Furthermore, reductions in MTR values in the fasciculus cuneatus, spinocerebellar, rubrospinal, and reticulospinal tracts were found in patients with DCM (adjusted p < 0.01 for all comparisons). Positive correlations between the JOA score and the MTR within the ventral columns of the spinal cord (R = 0.38, adjusted p < 0.05) and the ventral spinocerebellar tract (R = 0.41, adjusted p < 0.05) were revealed. CONCLUSION: The findings of our study indicate that demyelination in patients with DCM primarily affects the spinal tracts of the extrapyramidal system, and the extent of these changes is related to the severity of the condition.
Assuntos
Medula Cervical , Compressão da Medula Espinal , Doenças da Medula Espinal , Substância Branca , Humanos , Doenças da Medula Espinal/diagnóstico por imagem , Medula Espinal/diagnóstico por imagem , Medula Espinal/patologia , Imageamento por Ressonância Magnética/métodos , Medula Cervical/diagnóstico por imagem , Vértebras Cervicais/diagnóstico por imagem , Vértebras Cervicais/patologiaRESUMO
STUDY DESIGN: Prospective case-control study. OBJECTIVES: We investigated the use of the magnetization transfer saturation (MTsat) technique to assess the structural integrity of the spinal cord tracts in individuals with clinically significant degenerative cervical myelopathy (DCM) and associated disability. SETTING: Novosibirsk Neurosurgery Centre, Russia. METHODS: A total of 53 individuals diagnosed with DCM and 41 patients with cervical radiculopathy underwent high-resolution MRI of the cervical spinal cord via the magnetization transfer technique. The MRI data were processed using the Spinal Cord Toolbox (v5.5), with MTsat values determined for each spinal tract and compared between the two groups. Furthermore, associations between MTsat values and the clinical disability rates of patients were investigated. RESULTS: A significant decrease in the MTsat of the ventral spinocerebellar tract was observed in the DCM group compared to the control group (adjusted p < 0.001). There was a trend towards lower MTsat values in the rubrospinal tract in the DCM group (adjusted p = 0.08). Additionally, a decrease in MTsat values in the lateral funiculi of the spinal cord was found in patients with DCM (adjusted p < 0.01). Furthermore, a trend toward a positive correlation was observed between the JOA score and the MTsat values within the ventral spinocerebellar tract (R = 0.33, adjusted p = 0.051). CONCLUSIONS: The findings of our study indicate that demyelination in patients with DCM affects mainly the ventral spinocerebellar and rubrospinal tracts, and the extent of changes in the ventral spinocerebellar tract is related to the severity of the condition.
Assuntos
Imageamento por Ressonância Magnética , Doenças da Medula Espinal , Substância Branca , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Estudos de Casos e Controles , Estudos Prospectivos , Doenças da Medula Espinal/diagnóstico por imagem , Substância Branca/diagnóstico por imagem , Substância Branca/patologia , Idoso , Adulto , Vértebras Cervicais/diagnóstico por imagem , Medula Cervical/diagnóstico por imagem , Medula Cervical/patologia , Radiculopatia/diagnóstico por imagem , Radiculopatia/etiologiaRESUMO
BACKGROUND: In recent years, structural and functional reorganization of the brain and changes in brainstem structural connectivity have been shown in patients with degenerative cervical myelopathy (DCM). We hypothesized that volume loss in the basal ganglia, thalami, and brainstem structures exists and is associated with spinal cord compression severity in patients with DCM. METHODS: Forty-seven patients with DCM and 25 patients with cervical radiculopathy were evaluated using cervical spinal cord and brain magnetic resonance imaging (MRI). Brainstem structures, basal ganglia, and thalami volumes were evaluated with FreeSurfer and compared between groups with correction for individual intracranial volume, as well as patient age and sex. Additionally, spinal cord MRI data were analysed with the Spinal Cord Toolbox, and cross-sectional area (CSA) and fractional anisotropy (FA) values were calculated. Correlations between MR-morphometry data and spinal cord structural changes, as well as disease duration, were also evaluated in patients with DCM. RESULTS: A statistically significant reduction in the volume of the whole brainstem was revealed in the DCM group compared to the radiculopathy group (p < 0.01, FDR-corrected). Additionally, reductions in medulla oblongata, pons and midbrain volumes were found in patients with DCM (p < 0.01, p < 0.01 and p < 0.05, respectively, FDR-corrected). Additionally, a trend in the loss of volume of the left putamen was found (p = 0.087, FDR-corrected). Furthermore, medulla oblongata volume was correlated with spinal cord compression severity (R = 0.54, adjusted p < 0.001) and white matter damage (R = 0.46, adjusted p < 0.05) in patients with DCM. Negative correlations between the duration of the disease and the severity of spinal cord compression (R = -0.42, adjusted p < 0.05) and white matter damage (R = -0.49, adjusted p < 0.05) were also revealed, as well as a trend toward a negative association between the duration of the disease and the volume of the medulla oblongata (R = -0.35; adjusted p < 0.1). CONCLUSIONS: We revealed a reduction in the volume of brainstem structures in patients with DCM compared to patients with radiculopathy. Moreover, we found that these changes are associated with cord compression severity.
Assuntos
Medula Cervical , Radiculopatia , Compressão da Medula Espinal , Doenças da Medula Espinal , Humanos , Compressão da Medula Espinal/diagnóstico por imagem , Compressão da Medula Espinal/etiologia , Compressão da Medula Espinal/patologia , Doenças da Medula Espinal/patologia , Medula Espinal/patologia , Imageamento por Ressonância Magnética/métodos , Medula Cervical/diagnóstico por imagem , Medula Cervical/patologia , Tronco Encefálico/patologia , Vértebras Cervicais/patologiaRESUMO
BACKGROUND AND AIM: In recent decades, the use of various feed supplements is the current trend in poultry farming, among which phytogenics serve as alternatives to feed antibiotics. This study aimed to examine the effect of feeding various doses of milk thistle extract (Silybum marianum) on the morphological and biochemical parameters of the blood in broiler chickens. MATERIALS AND METHODS: Experiments were carried out in an industrial poultry farm on broiler chickens of the Hubbard ISA F15 cross for 40 days. One control group and five experimental groups of day-old chickens were formed. The number of birds in each group was 50. Broilers of all groups received complete feed, and the experimental groups received an additional milk thistle extract at doses of 0.1, 0.5, 1.0, 1.5, and 2.0 mg/kg of body weight. Milk thistle medicinal plant extract was obtained using water-ethanol extraction followed by low-temperature vacuum drying. For the assessment of blood analyses, samples were collected from the wing vein of six chickens per group. Using unified methods recommended by the International Federation of Clinical Chemistry, the content of red blood cells, hemoglobin, white blood cells, total protein, protein fractions, triglycerides, glucose, calcium, phosphorus, and the concentration of alanine aminotransferase and aspartate aminotransferase in the blood serum were determined. RESULTS: It was found that the introduction of milk thistle extract into the diet of broiler chickens with the aforementioned doses increased the number of red blood cells, hemoglobin, white blood cells in the blood, as well as a decrease in the level of albumin and an increase in the content of γ-globulins in its serum. CONCLUSION: The authors assume that the introduction of milk thistle extract into a complete feed for broiler chickens increased the anabolic processes in their bodies, accompanied by increased use of proteins of the albumin fraction as the main material for organogenesis.