# Structural and functional imaging markers in Degenerative Cervical Myelopathy

> **NIH NIH R01** · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · 2024 · $520,747

## Abstract

PROJECT SUMMARY/ABSTRACT
 Degenerative cervical myelopathy (DCM) is the most common cause of spinal injury in patients
over 55 years of age. It has a profound health care impact, leading to more than 100,000 operations a
year and upwards of $2 billion in health care expenditure. Unfortunately, traditional cervical spine MRI
techniques are imperfect predictors of ongoing spinal injury and cannot predict which patients will
respond well to intervention. Further, there is a critical gap in our understanding of how the spinal cord
is injured during ongoing degenerative compression. The application of new imaging technologies may
help close this gap. Our previous work, during K23 studies, has shown the utility of both white matter
(WM) imaging markers and spinal cord morphometrics for monitoring ongoing injury as well as
predicting recovery. The development of tract-specific WM imaging methods, as proposed in this work,
may aid in translating these findings to clinical care. Further, our work shows the volume of the cervical
cord gray matter (GM) is decreased in DCM. Utilizing a novel spinal cord fMRI methodology, we have
additionally seen decreased GM activation in DCM patients, a change that associates with patient
symptoms. These findings challenge the traditional view that DCM is a disease primarily of the WM. An
objective of our proposed studies is to utilize a newly developed Consensus spine imaging protocol to
substantiate the role of WM markers in tracking spinal injury, a critical next step in the translation of
these imaging results. Further, we develop a new fMRI methodology that is used to show that GM
activity is decreased in the injured cord. Our central hypothesis is that while markers of WM injury are
the leading predictor of symptoms of neural injury in DCM patients, GM injury also plays a key role in
each patient’s clinical symptoms. We will test this hypothesis by developing new tract specific markers
and novel spinal fMRI methodology. Building upon our previous experience, we will compare the
alterations of both WM and GM markers in these patients, with the goal of enhancing our ability to
accurately predict both ongoing injury and early recovery after surgery. These findings will have a
significant positive impact on human health by providing new understanding of the drivers of spinal
injury in degenerative cervical compressive disease and developing new markers of injury that may
enhance our ability to monitor and treat injury as well as prognosticate recovery.

## Key facts

- **NIH application ID:** 10910121
- **Project number:** 5R01NS129852-02
- **Recipient organization:** UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR
- **Principal Investigator:** Zachary Smith
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $520,747
- **Award type:** 5
- **Project period:** 2023-09-01 → 2028-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10910121

## Citation

> US National Institutes of Health, RePORTER application 10910121, Structural and functional imaging markers in Degenerative Cervical Myelopathy (5R01NS129852-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10910121. Licensed CC0.

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