Evidence map›Paper›PMID 38391699›Full record

ArticleBrain sciences2024

Motor Pathways Reorganization following Surgical Decompression for Degenerative Cervical Myelopathy: A Combined Navigated Transcranial Magnetic Stimulation and Clinical Outcome Study.

Alessandro Boaro, Sonia Nunes, Chiara Bagattini, Valeria Di Caro, Francesca Siddi, Fabio Moscolo, Christian Soda, Francesco Sala

Open access · goldAbstract read
In one paragraph

Article in Brain sciences, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.2field-weighted citation impact, top 50% 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

3 citing papers in PubMed, 1 citations in OpenAlex.

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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

8 authors at 3 institutions in 1 country.

Alessandro BoaroSection of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37124 Verona, Italy.ORCID 0000-0002-0856-1019
Sonia NunesSection of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37124 Verona, Italy.
Chiara BagattiniSection of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37124 Verona, Italy.
Valeria Di CaroSection of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37124 Verona, Italy.ORCID 0000-0001-7278-245X
Francesca SiddiSection of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37124 Verona, Italy.ORCID 0000-0002-0844-9289
Fabio MoscoloNeurosurgery Unit, Carlo Poma Hospital, 46100 Mantova, Italy.
Christian SodaInstitute of Neurosurgery, Azienda Ospedaliera Universitaria Integrata, 37126 Verona, Italy.
Francesco SalaSection of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37124 Verona, Italy.
University of Verona · ITAzienda Ospedaliera Carlo Poma · ITAzienda Ospedaliera Universitaria Integrata Verona · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

(1) Background: Degenerative cervical myelopathy is one of the main causes of disability in the elderly. The treatment of choice in patients with clear symptomatology and radiological correlation is surgical decompression. The application of navigated transcranial magnetic stimulation (nTMS) techniques has the potential to provide additional insights into the cortical and corticospinal behavior of the myelopathic cord and to better characterize the possible extent of clinical recovery. The objective of our study was to use nTMS to evaluate the effect of surgical decompression on neurophysiological properties at the cortical and corticospinal level and to better characterize the extent of possible clinical recovery. (2) Methods: We conducted a longitudinal study in which we assessed and compared nTMS neurophysiological indexes and clinical parameters (modified Japanese Orthopedic Association score and nine-hole pegboard test) before surgery, at 6 months, and at 12 months' follow-up in a population of 15 patients. (3) Results: We found a significant reduction in resting motor threshold (RMT; average 7%), cortical silent period (CSP; average 15%), and motor area (average 25%) at both 6 months and 12 months. A statistically significant linear correlation emerged between recruitment curve (RC) values obtained at follow-up appointments and at baseline (r = 0.95 at 6 months, r = 0.98 at 12 months). A concomitant improvement in the mJOA score and in the nine-hole pegboard task was observed after surgery. (4) Conclusions: Our results suggest that surgical decompression of the myelopathic spinal cord improves the neurophysiological balance at the cortical and corticospinal level, resulting in clinically significant recovery. Such findings contribute to the existing evidence characterizing the brain and the spinal cord as a dynamic system capable of functional and reversible plasticity and provide useful clinical insights to be used for patient counseling.

Indexed as

corticospinal reorganizationdegenerative cervical myelopathynTMSplasticity

Identifiers

PMID38391699
PMCPMC10887348
OpenAlexW4391224772

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Registered trials

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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.