Evidence for cervical cord tissue disorganisation with aging by diffusion tensor MRI.

This study investigated the influence of normal aging on cervical cord volumetry and diffusivity changes and assessed whether magnetic resonance imaging (MRI) abnormalities of the aging cervical cord and brain are associated. Conventional and diffusion tensor (DT) MRI of the brain and cervical cord were acquired from 96 healthy subjects (age range=13-70 years). Cross-sectional area, mean diffusivity (MD) and fractional anisotropy (FA) of the cervical cord were measured. Volumetry and diffusivity metrics were also obtained for the brain white matter (WM) and grey matter (GM) (overall and cortical). No cervical cord lesions were seen on conventional MR images from all subjects. Degenerative vertebral column changes (not associated to cord compression) were found in 41 subjects (43%). Average FA of the cervical cord, but not average MD and cross-sectional area, was correlated with age (r=-0.70, p<0.001). Additionally, T2 brain lesion volume, normalised brain volume (NBV), normalised global and cortical brain GM volumes and average MD of the brain GM and WM also correlated with age (r values ranging from -0.83 to 0.62). Only brain WM average FA was weakly correlated with cervical cord average FA (r=0.25, p=0.02). The final multivariate model retained cord average FA (r=-0.37, p<0.001), normalised cortical GM volume (r=-0.56, p<0.001) and NBV (r=-0.22, p=0.04) as independent correlates of age (r2=0.76). Cervical cord is vulnerable to aging. The decrease of FA, in the absence of atrophy and MD changes, suggests gliosis as the most likely pathological feature of the aging cord.