Upper cervical spinal cord morphometric charts: from population references to individualized clinical assessment
Wang, J.; Hua, T.; Wu, H.; Zhang, R.; Xu, S.; Zhang, C.; Chai, L.; Yao, Y.; Gao, T.; Bai, L.; Du, X.; Zhang, C.; Lin, B.; Liao, L.; Wang, H.; Luo, Y.; Zhu, X.; Deng, D.; Wu, Y.; Zhang, R.; Zhang, Z.; Zhou, F.; Zhu, J.; Zuo, X.-N.; Cheng, S.; Xia, X.; Meng, X.; Kong, Y.-Z.; Cohen-Adad, J.; Guo, R.; Xia, S.; Duan, Y.; Zhuo, Z.; Liu, Y.; Chinese Brain Health Imaging Consortium (CHART),
Show abstract
The upper cervical spinal cord is essential for motor, sensory and autonomic function, yet its normative morphometric trajectories and disease-related deviations remain unclear. Using three-dimensional T1-weighted images from 10,159 healthy individuals aged 8-85 years, we established normative references for averaged and level-specific upper cervical spinal cord morphometry, revealing measure-specific trajectories with peak ages of 29.7-44.1 years. These references were applied to 2,394 patients with seven neurological disorders: mild cognitive impairment, Alzheimer' s disease, Parkinson' s disease, cerebral small vessel disease, multiple sclerosis, neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease to derive individualized deviation scores. These deviation scores captured disease-specific abnormalities, enabled disease classification, and were associated with cognition, physical disability and disease progression. Finally, a personalized upper cervical spinal cord report was developed to support individualized imaging interpretation. Together, these findings provide a normative framework for quantifying upper cervical spinal cord morphometry and advancing personalized assessment across neurological disorders.
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