Evidence map›Paper›PMID 38113760›Full record

SynthesisEBioMedicine2024

Brain MRI changes in degenerative cervical myelopathy: a systematic review.

Amir Rafati Fard, Oliver D Mowforth, Melissa Yuan, Samuel Myrtle, Keng Siang Lee, Arka Banerjee, Maaz Khan, Mark R Kotter, Virginia F J Newcombe, Emmanuel A Stamatakis and 1 more

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in EBioMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Amir Rafati FardSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Oliver D MowforthDivision of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK. Electronic address: oliver.mowforth@nhs.net.
Melissa YuanSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Samuel MyrtleSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Keng Siang LeeDepartment of Neurosurgery, King's College Hospital, London, UK.
Arka BanerjeeSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Maaz KhanSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Mark R KotterDivision of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Virginia F J NewcombePACE Section, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Emmanuel A StamatakisPACE Section, Department of Medicine, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
Benjamin M DaviesDivision of Academic Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK.
University of Cambridge · GBAddenbrooke's Hospital · GBKing's College Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDegenerative cervical myelopathy (DCM) is the most common cause of adult spinal cord dysfunction globally. Associated neurological symptoms and signs have historically been explained by pathobiology within the cervical spine. However, recent advances in imaging have shed light on numerous brain changes in patients with DCM, and it is hypothesised that these changes contribute to DCM pathogenesis. The aetiology, significance, and distribution of these supraspinal changes is currently unknown. The objective was therefore to synthesise all current evidence on brain changes in DCM.

methodsA systematic review was performed. Cross-sectional and longitudinal studies with magnetic resonance imaging on a cohort of patients with DCM were eligible. PRISMA guidelines were followed. MEDLINE and Embase were searched to 28th August 2023. Duplicate title/abstract screening, data extraction and risk of bias assessments were conducted. A qualitative synthesis of the literature is presented as per the Synthesis Without Meta-Analysis (SWiM) reporting guideline. The review was registered with PROSPERO (ID: CRD42022298538).

findingsOf the 2014 studies that were screened, 47 studies were identified that used MRI to investigate brain changes in DCM. In total, 1500 patients with DCM were included in the synthesis, with a mean age of 53 years. Brain alterations on MRI were associated with DCM both before and after surgery, particularly within the sensorimotor network, visual network, default mode network, thalamus and cerebellum. Associations were commonly reported between brain MRI alterations and clinical measures, particularly the Japanese orthopaedic association (JOA) score. Risk of bias of included studies was low to moderate.

interpretationThe rapidly expanding literature provides mounting evidence for brain changes in DCM. We have identified key structures and pathways that are altered, although there remains uncertainty regarding the directionality and clinical significance of these changes. Future studies with greater sample sizes, more detailed phenotyping and longer follow-up are now needed.

fundingODM is supported by an Academic Clinical Fellowship at the University of Cambridge. BMD is supported by an NIHR Clinical Doctoral Fellowship at the University of Cambridge (NIHR300696). VFJN is supported by an NIHR Rosetrees Trust Advanced Fellowship (NIHR302544). This project was supported by an award from the Rosetrees Foundation with the Storygate Trust (A2844).

Indexed as

Spinal Cord DiseasesBrainCross-Sectional StudiesHumansMagnetic Resonance ImagingMiddle AgedCervicalFunctionalMagnetic Resonance ImagingMyelopathyStructural

Identifiers

PMID38113760
PMCPMC10772405
OpenAlexW4389912696

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.