Miloš Keřkovský

Are subjects with spondylotic cervical cord encroachment at increased risk of cervical spinal cord injury after minor trauma

The aim of the study was to analyse the risk of symptomatic myelopathy after minor trauma in patients with asymptomatic spondylotic cervical spinal cord encroachment (ASCCE). In a cohort of 199 patients with ASCCE, previously followed prospectively in a study investigating progression into symptomatic myelopathy, the authors looked retrospectively for traumatic episodes that may have involved injury to the cervical spine. A questionnaire and data file analysis were employed to highlight whatever hypothetical relationship might emerge with the development of symptomatic myelopathy. Fourteen traumatic episodes in the course of a follow-up of 44 months (median) were recorded in our group (who had been instructed to avoid risky activities), with no significant association with the development of symptomatic myelopathy (found in 45 cases). Only three minor traumatic events without fracture of the cervical spine were found among the symptomatic myelopathy cases, with no chronological relationship between trauma and myelopathy. Furthermore, 56 traumatic spinal cord events were found before the diagnosis of cervical cord encroachment was established, with no correlation to either type of compression (discogenic vs osteophytic). In conclusion, the risk of spinal cord injury after minor trauma of the cervical spine in patients with ASCCE appeared to be low in our cohort provided risky activities in these individuals are restricted. Implementation of preventive surgical decompression surgery into clinical practice in these individuals should be postponed until better-designed studies provide proof enough for it to take precedence over a conservative approach.

Spinal Cord MR Diffusion Properties in Patients with Degenerative Cervical Cord Compression

Diffusion tensor imaging (DTI) has previously been used as a biomarker of myelopathy in patients with degenerative cervical cord compression (DCCC). However, many factors may affect the diffusion properties of the spinal cord. This prospective study seeks to identify sources of variability in spinal cord DTI parameters in both DCCC patients and healthy subjects.

Psychosis effect on hippocampal reduction in schizophrenia

INTRODUCTION In schizophrenia, disruption of the neurodevelopmental processes may lead to brain changes and subsequent clinical manifestations of the illness. Reports of the progressive nature of these morphological brain changes raise questions about their causes. The possible toxic effects of repeated stressful psychotic episodes may contribute to the disease progression. OBJECTIVES To analyze the influence of illness duration and previous psychotic episodes on hippocampal gray matter volume (GMV) in schizophrenia. METHODS We performed an analysis of hippocampal GMV correlations with illness duration, number of previous psychotic episodes, and age in 24 schizophrenia patients and 24 matched healthy controls. RESULTS We found a cluster of GMV voxels in the left hippocampal tail that negatively correlated with the number of previous psychotic episodes, independent from the effect of age. On the other hand we found no effect of illness duration independent of age on the hippocampal GMV. Finally, we found a cluster of significant group-by-age interaction in the left hippocampal head. CONCLUSIONS We found an additive adverse effect of psychotic episodes on hippocampal morphology in schizophrenia. Our findings support toxicity of psychosis concept, together with etiological heterogeneity of brain changes in schizophrenia.

Analysis of diffusion tensor measurements of the human cervical spinal cord based on semiautomatic segmentation of the white and gray matter: Segmentation of GM/WM of Cervical Spine

Segmentation of the gray and white matter (GM, WM) of the human spinal cord in MRI images as well as the analysis of spinal cord diffusivity are challenging. When appropriately segmented, diffusion tensor imaging (DTI) of the spinal cord might be beneficial in the diagnosis and prognosis of several diseases.

Diffusion Tensor Imaging in Radiation-Induced Myelopathy

Radiation myelopathy (RM) is a rare complication of spinal cord irradiation. Diagnosis is based on the history of radiotherapy, laboratory tests, and magnetic resonance imaging of the spinal cord. The MRI findings may nevertheless be quite unspecific. In this paper, we describe the findings of diffusion tensor imaging in a case of the delayed form of RM. We observed areas of restricted diffusion within the spinal cord which probably corresponded to the ischemic changes. This would concur with the currently accepted pathogenetic theory concerning RM.