Charting Cervical Spinal Cord Morphometry Across the Lifespan.
Authors
Affiliations (29)
Affiliations (29)
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- Vanderbilt University Institute of Imaging Science, Nashville, Tennessee, USA.
- Department of Computer Science, Vanderbilt University, Nashville, Tennessee, USA.
- Department of Electrical and Computer Engineering, Vanderbilt University, Nashville, Tennessee, USA.
- Medical Scientist Training Program, Vanderbilt University, Nashville, Tennessee, USA.
- Vanderbilt University Medical Center, Vanderbilt Memory and Alzheimer's Center, Nashville, Tennessee, USA.
- Vanderbilt University Medical Center, Vanderbilt Genetics Institute, Nashville, Tennessee, USA.
- Vanderbilt University, Vanderbilt Brain Institute, Nashville, Tennessee, USA.
- Vanderbilt Alzheimer's Disease Research Center, Nashville, Tennessee, USA.
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA.
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- Department of Biomedical Engineering, Vanderbilt University, Nashville, Tennessee, USA.
- Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- Laboratory of Behavioral Neuroscience, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA.
- Department of Special Education, Peabody College of Education and Human Development, Nashville, Tennessee, USA.
- Life Span Institute and Department of Psychology, University of Kansas, Lawrence, Kansas, USA.
- Department of Computer Science, Park University, Parkville, Missouri, USA.
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, Quebec, Canada.
- CHU Sainte-Justine Research Centre, Montréal, Quebec, Canada.
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
- Departments of Neurosurgery and Neurology, Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czechia.
- Department of Biomedical Engineering, University Hospital Olomouc, Olomouc, Czechia.
- Centre de recherche du CHU Sainte-Justine, Montréal, Canada.
- Department of Computer Engineering and Software Engineering, Polytechnique Montréal, Montréal, Canada.
- Functional Neuroimaging Unit, CRIUGM, Université de Montréal, Montreal, Quebec, Canada.
- Mila-Quebec AI Institute, Montreal, Quebec, Canada.
Abstract
Spinal cord morphometry provides essential biomarkers of neurological health, but clinical interpretations are confounded by inter-subject variability and a lack of normative references across the full human lifespan. We address this gap by generating the first comprehensive lifespan charts for cervical spinal cord morphometry. From 78,269 T1-weighted brain MRI sessions, we identified a final cross-sectional cohort of 24,251 healthy or cognitively normal controls from 33 datasets (ages 0-100 years) with cervical cord coverage. To overcome contrast variability, we employed a state-of-the-art contrast-agnostic deep learning segmentation method, extracting cross-sectional area (CSA), anteroposterior (AP) and right-left (RL/transverse), and shape indices (AP/RL ratio, eccentricity, and solidity) from C1 to C7. Normative trajectories were modeled using Generalized Additive Models for Location, Scale, and Shape (GAMLSS). The resulting charts reveal distinct non-linear lifespan changes: rapid growth through childhood and adolescence, peak maturation occurring in early-to-mid adulthood (e.g., mid-30s for CSA), followed by gradual decreases. Significant regional variations along the cervical cord and consistent sex differences (males > females for size metrics) were quantified. Spinal cord trajectories showed strong temporal coupling with brain white matter and brainstem volumes, suggesting integrated CNS development and aging. These lifespan charts provide a robust normative framework, enabling age- and sex-specific centile scoring of individual spinal cord morphometry. This resource offers a critical tool for differentiating typical variation from pathological changes, enhancing the clinical utility of spinal cord MRI in studies of development and neurodegeneration.