Structural Relationship between Cerebral Gray and White Matter Alterations in Degenerative Cervical Myelopathy
, Francesco Sanvito 1,2,3, Talia C. Oughourlian 1,4, Sabah Islam 1, Noriko Salamon 2, Langston T. Holly 5 and Benjamin M. Ellingson 1,2,6Round 1
Reviewer 1 Report
Review to the manuscript „Structural Relationship between Cerebral Gray and White Matter Alterations in Degenerative Cervical Myelopathy“
Wang et al. present a manuscript concerning the structural relationship between cerebral gray and white matter alterations in patients with degenerative cervical myelopathy. The current study examined for the first time the alterations of cortical thickness in DCM patients and demonstrated that the extent of these changes were correlated with the degree of neurological impairment. The authors concluded that that DCM may cause a widespread gray matter alterations and underlying subcortical neurite loss, which may serve as potential imaging biomarkers reflecting the pathology of DCM.
Nevertheless, the current manuscript contains of several limitations:
- First of all the limited number of included patients (n=61). Additionally, the authors did not match ill patients (7 DCM patients and 7 patients with asymptomatic spinal cord compression) with healthy patients in a 1:1 modus.
- The authors use too much abbreviations in the manuscript, especially within the abstract. Furthermore, abbreviations should be explained at their first mention
- In addition, the manuscript is structured in confusions manner. Why did they mixed patients with asymptomatic spinal cord compression and patients with DCM?
- Additionally, the linguistically style is very difficult to understand
The authors should explain the benefit of their results for the daily practice in a more extensively manner
Author Response
We would like to thank the reviewer for the positive feedback and insightful comments. We have attempted to address each comment to the best of our ability in the revised manuscript.
Author Response File: 
Author Response.docx
Reviewer 2 Report
Interesting paper from a group that has been active investigators in the field of supraspinal changes in patients with DCM. The research adds to the growing body of literature in the subject. I have 1 major concern, that has been previously communicated to the authors when I reviewed another papers of theirs which needs to be addressed, and a couple of minor changes.
The major change is the incorrect classification of asymptomatic patients as patients with DCM (table 1), this group represents a seperate group which may be considered subclinical, or asymptomatic spinal cord compression etc.
Minor changes - please review the paper for minor spelling changes
Some examples:
page 3 line 115 "spimal"
page 3 line 102 "endorsed" not the best choice of words, consider presented with, complained of, described, etc
Author Response
We would like to thank the reviewer for the positive feedback and insightful comments. We have attempted to address each comment to the best of our ability in the revised manuscript.
Author Response File: Author Response.docx
Round 2
Reviewer 1 Report
The manuscript is clearly improved after revision.
