Thalamic MRS and cervical DTI changes in cervical spondylotic myelopathy versus healthy controls

This prospective imaging study enrolled 93 patients with cervical spondylotic myelopathy (CSM) and 67 healthy controls between December 2023 and September 2024. The stated purpose was to examine thalamic metabolite changes using magnetic resonance spectroscopy (MRS) and their relationship to spinal cord injury severity assessed with diffusion tensor imaging (DTI).

All participants underwent routine cervical spine MRI, MRS of the bilateral thalamus, and DTI of the cervical spine. Investigators compared DTI parameters (FA, ADC) and MRS ratios (NAA/Cr, Cho/Cr, MI/Cr, Glx/Cr) between groups, performed correlation analyses across clinical features, cervical MRI findings, and imaging parameters, and built multivariate linear regression models for thalamic metabolites.

Cervical FA values were significantly lower in the CSM group than in controls (p = 0.005, t = 2.874). NAA/Cr in the thalamus was also reduced in the CSM group relative to controls; additional MRS ratio comparisons and absolute values are truncated in the available abstract text. The available text does not report specific effect sizes for NAA/Cr or detailed regression coefficients.

Because this was a non-interventional imaging study, safety, adverse events, and tolerability are not applicable and were not reported. The abstract does not describe recruitment setting, funding, or conflicts of interest, and no follow-up duration is specified given the cross-sectional imaging comparison.

Clinically, the findings are hypothesis-generating: they support the concept that cervical cord compression may be accompanied by remote thalamic metabolic changes detectable on MRS, but the observational design, single-timepoint comparison, and incomplete results text limit any direct change to imaging practice.