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Kann MR, Lavadi RS, Crane A, Aizooky T, Hardi A, Polavarapu H, Kumar RP, Mitha R, Shah M, Hamilton DK, Agarwal N. Fluid biomarkers for cervical spondylotic myelopathy. Neurosurg Rev 2025; 48:232. [PMID: 39945892 DOI: 10.1007/s10143-025-03217-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 12/02/2024] [Accepted: 01/07/2025] [Indexed: 05/09/2025]
Abstract
INTRODUCTION There is a scarcity of literature exploring fluid-based biomarkers that have the potential to provide deeper insights into the cellular mechanisms underlying cervical spondylotic myelopathy (CSM) symptom presentation and postoperative recovery. This systematic review synthesized the literature on invasive, fluid-based biomarkers and their clinical significance with CSM. MATERIALS AND METHODS A comprehensive search strategy was developed for concepts of biomarkers and CSM. Retrieved results underwent title, abstract, and full-text screening with inclusion criteria being original research including animal or human subjects affected by CSM/compression myelopathy that investigated the relationship between a fluid-based biomarker and CSM. Risk-of-bias was reported using the OHAT Risk of Bias Rating Tool. RESULTS The search strategy resulted in 191 unique manuscripts, with 20 meeting the predetermined inclusion/exclusion criteria, included in final analysis. Of these, 15 (75.0%) were human studies, two (10.0%) were animal studies, and three studies (15.0%) included both human and animal subjects. Across human studies, the fluid utilized for biomarker assessment was blood, (N = 8, 44.4%), cerebrospinal fluid (CSF) (N = 9, 50.0%), and both blood and CSF (N = 1, 5.6%). The three most common biomarkers assessed across human studies were NSE (N = 4, 22.2%), S100b (N = 4, 22.2%), and pNF-H (N = 4, 22.2%). Risk of bias due to inadequate comparison groups was present in three human studies (16.7%) and two animal studies (40%). CONCLUSIONS This comprehensive systematic review identified several associations between blood and CSF-based neural, glial, and inflammatory biomarkers and CSM. However, the vast heterogeneity across studies renders it difficult to draw definitive conclusions. Future research within larger, prospective patient cohorts is needed to fully elucidate the utility these biomarkers may hold in the clinical evaluation of patients with CSM.
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Affiliation(s)
- Michael R Kann
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raj Swaroop Lavadi
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alex Crane
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Taim Aizooky
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Angela Hardi
- Becker Medical Library, Washington University School of Medicine, St. Louis, MO, USA
| | - Hanish Polavarapu
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rohit Prem Kumar
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Rida Mitha
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Manan Shah
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - D Kojo Hamilton
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Nitin Agarwal
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
- Neurological Surgery, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.
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Zheng J, Zhang Y, Zhao B, Wang N, Gao T, Zhang L. Metabolic changes of thalamus assessed by 1H-MRS spectroscopy in patients of cervical spondylotic myelopathy following decompression surgery. Front Neurol 2025; 15:1513896. [PMID: 39845933 PMCID: PMC11750645 DOI: 10.3389/fneur.2024.1513896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Accepted: 12/12/2024] [Indexed: 01/24/2025] Open
Abstract
Objective To assess the changes of thalamic metabolites before and after surgery in patients with Cervical Spondylotic Myelopathy (CSM) using Hydrogen Proton Magnetic Resonance Spectroscopy (1H-MRS) and to investigate its association with improvement in neurological function. Methods Forty-eight CSM patients who underwent cervical decompression surgery from December 2022 to June 2023 were included, and 33 healthy volunteers were recruited. All subjects underwent bilateral thalamic 1H-MRS scans before the surgical procedure, and subsequently again 6 months later. Neurological function was assessed pre-operatively and post-operatively (6 months) in all patients with CSM using the modified Japanese Orthopedic Association (mJOA). The changes of mJOA (ΔmJOA = postoperative mJOA-preoperative mJOA) were employed as an indicator of neurological improvement. The pre- and postoperative metabolic ratio of N-acetylaspartate/creatine (NAA/Cr), choline/creatine (Cho/Cr), myo-inositol/creatine (mI/Cr), glutamate and glutamine complex/creatine (Glx/Cr) were statistically compared in CSM patients and healthy controls (HCs). A correlation analysis was conducted to determine the relationship between alterations in pre- and postoperative metabolite ratios (ΔNAA/Cr, ΔCho/Cr, ΔmI/Cr, ΔGlx/Cr) and ΔmJOA. Results Compared to the HCs, patients with CSM showed significantly lower pre- and post-operative NAA/Cr (Z = -4.235, p < 0.001; Z = -3.184, p = 0.001), Cho/Cr (Z = -5.050, p < 0.001; (Z = -2.624, p = 0.007) and mI/Cr (Z = -3.739, p = 0.001; Z = -2.014, p = 0.044). There was no difference in Glx/Cr between patients in patients with CSM, either preoperatively or postoperatively, compared to HCs. Post-operative NAA/Cr (Z = -2.285, p = 0.041) and mI/Cr (Z = -2.925, p = 0.021) were increased in CSM patients compared to pre-operative NAA/Cr and mI/Cr. In CSM patients, ΔmI/Cr correlated significantly with ΔmJOA (r = 0.507, p < 0.001). Conclusion The preliminary findings indicate that metabolites in the thalamus of CSM patients exhibit changes following surgery. Additionally, it has been demonstrated that elevated postoperative mI correlates with improvements in neurological function.
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Affiliation(s)
- Jiangqin Zheng
- Department of Radiology, Hainan Maternal and Child Health Centre, Haikou, China
| | - Yujin Zhang
- Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baogen Zhao
- Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ning Wang
- Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Ting Gao
- Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Li Zhang
- Department of Radiology and Nuclear Medicine, The First Hospital of Hebei Medical University, Shijiazhuang, China
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Veshchitskii A, Shkorbatova P, Merkulyeva N. Neurochemical atlas of the rabbit spinal cord. Brain Struct Funct 2024; 229:2011-2027. [PMID: 39115602 DOI: 10.1007/s00429-024-02842-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 07/15/2024] [Indexed: 10/18/2024]
Abstract
Complex neurophysiological and morphologic experiments require suitable animal models for investigation. The rabbit is one of the most successful models for studying spinal cord functions owing to its substantial size. However, achieving precise surgical access to specific spinal regions requires a thorough understanding of the spinal cord's cytoarchitectonic structure and its spatial relationship with the vertebrae. The comprehensive anatomo-neurochemical atlases of the spinal cord are invaluable for attaining such insight. While such atlases exist for some rodents and primates, none exist for rabbits. We have developed a spinal cord atlas for rabbits to bridge this gap. Utilizing various neurochemical markers-including antibodies to NeuN, calbindin 28 kDa, parvalbumin, choline acetyltransferase, nitric oxide synthase, and non-phosphorylated heavy-chain neurofilaments (SMI-32 antibody)-we present the visualization of diverse spinal neuronal populations, various spinal cord metrics, stereotaxic maps of transverse slices for each spinal segment, and a spatial map detailing the intricate relationship between the spinal cord and the vertebrae across its entire length.
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Affiliation(s)
- Aleksandr Veshchitskii
- Neuromorphology Lab, Pavlov Institute of Physiology Russian Academy of Sciences, Saint Petersburg, Russia, 199034
| | - Polina Shkorbatova
- Neuromorphology Lab, Pavlov Institute of Physiology Russian Academy of Sciences, Saint Petersburg, Russia, 199034
| | - Natalia Merkulyeva
- Neuromorphology Lab, Pavlov Institute of Physiology Russian Academy of Sciences, Saint Petersburg, Russia, 199034.
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Effect of the olive leaf extract in chronic spinal cord injury model: an experimental research. Ann Med Surg (Lond) 2023; 85:365-372. [PMID: 36923747 PMCID: PMC10010806 DOI: 10.1097/ms9.0000000000000085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/27/2022] [Indexed: 03/18/2023] Open
Abstract
Posttraumatic myelopathy is defined as a spinal cord injury (SCI) that results in varying degrees of motor and sensory deficits. The degree of 'secondary damage,' which is caused by a variety of cellular, molecular, and biochemical cascades is linked to the outcome of SCI. According to research, the beneficial effects of oleuropein and its derivatives have been linked to radical scavenging/antioxidant actions and anti-inflammatory effects. Materials and Methods This study was divided into six groups: control negative (sham-operated) group, control positive 1 and 2 (early chronic and chronic), treatment groups 1, 2, and 3 (prophylactic, concomitant, and late). Olive leaf extract (OLE) given dose was 350 mg/kg body weight. Blood was taken from the left corotic artery before the animals were terminated, seromarker assessment, enzyme-linked immunosorbent assay of IL-6, TNF-α, brain-derived neurotrophic factor (BDNF), and assessment of functional motoric outcome before the animal was terminated. Results Chronic spinal cord compression increased serum levels of IL-6, TNF-α, and decreased serum level of BDNF. OLE 350 mg/kg body weight decreased serum levels of IL-6, TNF-α and increased functional motoric outcome, especially in prophylactic and concomitant therapy. Discussion These findings indicate that OLE may be effective in protecting chronic SCI model. Conclusion Oleuropein has a potential effect to reduce the IL-6 and TNF-α in rabbit model of SCI, and the BDNF value risen after the administration of Oleuropein.
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Anggraini DR, Ilyas S, Hasibuan PAZ, Machrina Y, Purba A, Munir D, Putra IB, Betty. Anti-Aging Activity of Andaliman (Zanthoxylum Acanthopodium DC) Fruit Ethanol Extract on Brain Weight and p16INK4a Expression of Hippocampus in Aging Model Rats. Acta Inform Med 2022; 30:283-286. [PMID: 36467322 PMCID: PMC9665423 DOI: 10.5455/aim.2022.30.283-286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 10/18/2022] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Physiological aging and due to oxidative stress in long term will have an impact on cellular response disorders, can caused aging of hippocampus and senility. Brain weight is known to decrease with age and p16INK4a as aging biomarkers have been investigated. Andaliman is one of typical herbal plants from North Sumatra has been widely used as an antioxidant, anti-inflammatory and anti-aging. OBJECTIVE This study was evaluated effect of andaliman (Zanthoxylum acanthopodium DC) fruit ethanol extract (AEE) on brain weight and p16INK4a expression in aging model rats. METHODS This study was carried out experimentally of 24 male wistar rats. The treatment group consisted of 4 groups; KN= negatif control (normal), KP= positif control (aging model rat), P1 and P2= aging model rat + AEE at dose 150 and 300mg/kgbw, respectively. The aging model rats were D-galactose-induced at dose of 150mg/kgbw for 8 weeks. Brain weigth were recorded by digital scales. p16INK4a expression using immunohistochemical methods. The data analysis with Anova test. RESULTS This study showed differences brain weight between groups (p=0.523). Brain weight in P1 (1.34±0,06) and P2 (1.30±0.09) tendency increased than KP (1.29±0.62). The p16INK4a expression between groups significant difference (p=0.041), continued with post hoc Least Significant Difference (LSD) showed p16INK4a expression in KN significant decreased than KP (p=0.027). Likewise, p16INK4a expression in P2 was significant decreased than KP (p=0.010). CONCLUSION Andaliman ethanol extract at a dose 300mg/kgbw for 8 weeks was improved aging process caused D-galactose induced.
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Affiliation(s)
- Dwi Rita Anggraini
- Philosophy Doctor in Medicine Program, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
- Department of Anatomy, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Syafruddin Ilyas
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Yetty Machrina
- Department of Physiology, Faculty of Medicine,Universitas Sumatera Utara, Medan, Indonesia
| | - Ambrosius Purba
- Physiology Division, Department of Biomedical Sciences, Faculty of Medicine, Universitas Padjadjaran, Jatinangor, Indonesia
| | - Delfitri Munir
- Department of Ear, Nose & Throat, Head & Neck, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Imam Budi Putra
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Betty
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Ibrahim S, Nasution IFA, Danil M, Sadewo W, Widyawati T, Eyanoer PC, Dharmajaya R, Ritarwan K, Riawan W, Loe ML, Hutagalung TR. Olive Polyphenol as Neuroprotective in Chronic Cervical Myelopathy Rabbit Model. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Olive polyphenols are known to be an anti-oxidants and anti-inflammatory agents.
AIM: The purpose of this study was to determine the potential neuroprotective effect on chronic cervical myelopathy rabbit model.
METHODS: This study was divided into six groups; control negative (Sham-Operated) group, control positive 1 and 2, treatment groups 1, 2, and 3. Olive leaf extract (OLE) gives 350 mg/kg BW and spinal cord sample was taken at the compression level C5. Histopathological assessment and immunohistochemistry of neurofilaments (NF), S-100, brain derived neurotrophic factor (BDNF), and evaluation of functional motoric outcome were done before animals were terminated.
RESULTS: Chronic cervical myelopathy in rabbit model causes decreased expression of NF, S-100, BDNF, and decreased motor function. Oral administration of OLE increased the expression of these biomarkers and improved motor function outcomes.
DISCUSSION: These findings indicate that OLE may be effective in protecting chronic cervical myelopathy in rabbit model.
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Potential benefit of olive leaf extract in cervical spondylotic myelopathy model. Ann Med Surg (Lond) 2022; 73:103040. [PMID: 35003721 PMCID: PMC8717420 DOI: 10.1016/j.amsu.2021.103040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/23/2022] Open
Abstract
Introduction Cervical spondylosis is the most common cause of myelopathy in the cervical due to chronic compression of the spinal cord in patients aged 55 years or older. Recent studies suggest that olive extracts suppress inflammation and reduce stress oxidative injury. The purpose of this study was to determine the potential neuroprotective effects of olive leaf extract (OLE) in an experimental cervical spondylotic myelopathy model. Methods This study was divided into 6 groups; Control Negative (Sham-Operated) Group, Control Positive 1 & 2 (early chronic and chronic), Treatment Groups 1, 2 & 3 (prophylactic, concomitant & late). Olive leaf extract (OLE) give 350 mg/kg BW and spinal cord sample was taken at the compression level C5. Histopathological assessment and immunohistochemistry of Amyloid-β, p-Tau, TDP-43 dan CD-68 dan evaluation of functional motoric outcome was done before animals were terminated. Results Chronic spinal cord compression increased the expression of Amyloid-β, p-Tau, TDP-43 dan CD-68. OLE 350 mg/kg BW decreased the expression of these biomarkers and increased functional motoric outcome, especially as prophylactic dan concomitant treatment. Discussion These findings indicate that OLE may be effective in protecting cervical spondylotic myelopathy. Cervical Spondylotic Myelopathy. Spine. Amyloid-β. p-Tau. TDP-43. CD-68.
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