Priority 22 from the Degenerative Cervical Myelopathy PSP

UNCERTAINTY: Can CSF or serum biomarkers be identified to support early diagnosis of DCM, and/or predict treatment outcomes? (JLA PSP Priority 22)
Overall ranking	22
JLA question ID	0097/22
Explanatory note	There is limited evidence to suggest that routinely-collected clinical and imaging factors can predict the onset of DCM and detect early neurological deterioration. Recent studies have attempted to use various imaging biomarkers to quantify axonal/myeln injury, cellular inflammation, neuronal loss and white matter changes. These approaches may have the potential to improve diagnosis, monitor progression and predict treatment outcomes. A pilot study by Jenis et al (2011) identified important differences in the cerebrospinal fluid between normal controls and patents with DCM. Proteonomic analysis of the cerebrospinal fluid revealed that patients with DCM have decreased human brain-derived neurotropic factor and pigment epithelium derived factor and elevated apolipoprotein A-1 and vascular endothelial growth factor.
Evidence	No systematic reviews, scoping reviews or guidelines identified
Health Research Classification System category	Neurological

Extra information provided by this PSP
Original uncertainty examples	Bio markers for early diagnosis? ~ Could we get any clues about DCM from analysing the CSF? ~ Is it possible to find a serum biomarker that predict the prognosis of DCM? ~ What is the role of biomarkers in the diagnosis and follow-up of patients with DCM?
Submitted by	Spinal Surgeons x 11, Other healthcare professionals x 1, People with DCM and their supporters x 1

PSP information
PSP unique ID	0097
PSP name	Degenerative Cervical Myelopathy
Total number of uncertainties identified by this PSP.	76 (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop	20 November 2019