Introduction:
Degenerative Cervical Myelopathy (DCM) refers to the chronic mechanical compression of the spinal cord caused by degenerative changes in the cervical spine. It is the most prevalent cause of spinal cord dysfunction worldwide, carrying a major economic and functional burden. There is evidence that DCM may be associated with cognitive dysfunction, but this relationship is poorly understood.
Methods:
The MYelopathy NAtural History (MYNAH) registry was used as the source of data for analysis. The MYNAH registry provided data on cognitive outcomes, disease severity, treatment outcomes, and a range of other demographic variables for use in a prospective, longitudinal study. At the time of analysis, there was 60 baseline measurments, 14 of which had conducted the full 4 follow-ups across a 2-year period. Primary outcomes included cognitive dysfunction measured by the blind/telephone Montreal Cognitive Assessment (MoCA), and its association with different disease severity markers including the mJOA, Nurick Grade, NDI, EQ-5D, and EQ-VAS. Linear mixed modelling was conducted to assess for associations between these outcomes.
Results:
The average initial blind/telephone MoCA score was 20.6 across the MYNAH patients. This did not change significantly across the 4 follow-ups. There was no statistically significant association found between MoCA scores and disease severity. The effects predictor estimated small changes in MoCA and disease severity measures between +1.5 to -0.7, but all p-values were >0.05. Thus, MoCA scores did not predict disease severity measures, and disease severity measures did not predict MoCA scores.
Conclusion:
Preliminary data suggests there is no association between cognitive dysfunction and DCM diagnosis, progression, and management. The analysis was limited by a small sample size and a small range of cognitive outcomes across the recruited patients. Future re-evaluation in more cognitively impaired or larger patient groups may provide different outcomes.