Upper cervical spinal cord morphometric charts: from population references to individualized clinical assessment
Year: 2026
Type: preprint
Study design: Observational Study
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.
Source: medRxiv
Authors: Jiajia Wang, Tiantian Hua, Haiyan Wu, Rui Zhang, Siyao Xu, Cong Zhang, Li Chai, Yajun Yao, Tianyu Gao, Lu Bai, Xiaozhou Du, Chao Zhang, Bingjie Lin, Lifang Liao, Huiying Wang, Yuqi Luo, Xiaoqin Zhu, Demao Deng, Yuankui Wu, Renlong Zhang, Zhiqiang Zhang, Fuqing Zhou, Jiajia Zhu, Xi-Nian Zuo, Shufang Cheng, Xiaona Xia, Xiangshui Meng, Ya-Zhuo Kong, Julien Cohen-Adad, Ruomi Guo, Shuiwei Xia, Yunyun Duan, Zhizheng Zhuo, Yaou Liu
Institutions: Capital Medical University, Beijing Tian Tan Hospital, University of Macau, Neusoft Medical Systems Co., Ltd. (China), Second Hospital of Hebei Medical University, Tianjin First Center Hospital, Tianjin Medical University General Hospital, State Key Laboratory of Experimental Hematology, Tianjin Medical University, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanfang Hospital, Southern Medical University, Nanjing General Hospital of Nanjing Military Command, Nanjing University, Nanchang University, First Affiliated Hospital of Nanchang University, First Affiliated Hospital of Anhui Medical University, Beijing Normal University, State Key Laboratory of Cognitive Neuroscience and Learning, Wenzhou Medical University, Shandong University, Chinese Academy of Sciences, University of Oxford, Wellcome Centre for Integrative Neuroimaging, Institute of Psychology, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Mila - Quebec Artificial Intelligence Institute, CHU Sainte-Justine Research Center, Polytechnique Montréal, Université de Montréal, Third Affiliated Hospital of Sun Yat-sen University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G4268326514, G6779012343
OpenAlex ID: W7221531065