Charting Cervical Spinal Cord Morphometry Across the Lifespan
- 1Vanderbilt University Institute of Imaging Science
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.
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BibTeX
@misc{schilling2026charting,
title = {{Charting Cervical Spinal Cord Morphometry Across the Lifespan}},
author = {K. G. Schilling and M. E. Kim and M. Amandola and C. Gao and K. Ramadass and P. Kanakaraj and S. Bogdanov and G. Rudravaram and N. R. Newlin and D. Archer and T. J. Hohman and A. L. Jefferson and V. L. Morgan and A. Roche and D. J. Englot and M. Bilgel and L. L. Beason Held and L. Ferrucci and L. Cutting and L. A. Barquero and M. A. Darchangel and T. Q. Nguyen and K. L. Humphreys and Y. Niu and S. Vinci-Booher and C. J. Cascio and The HABS-HD Study Team and Alzheimers Disease Neuroimaging Initiative and The BIOCARD Study Team and Z. Li and D. Moyer and S. N. Vandekar and P. Zhang and S. St-Onge and S. Bedard and J. Valosek and B. De Leener and J. Cohen-Adad},
howpublished = {bioRxiv},
year = {2026},
month = jun,
doi = {10.64898/2026.06.03.729823},
url = {https://www.biorxiv.org/content/10.64898/2026.06.03.729823v2},
note = {CC BY},
}
RIS
TY - UNPB
TI - Charting Cervical Spinal Cord Morphometry Across the Lifespan
AU - K. G. Schilling
AU - M. E. Kim
AU - M. Amandola
AU - C. Gao
AU - K. Ramadass
AU - P. Kanakaraj
AU - S. Bogdanov
AU - G. Rudravaram
AU - N. R. Newlin
AU - D. Archer
AU - T. J. Hohman
AU - A. L. Jefferson
AU - V. L. Morgan
AU - A. Roche
AU - D. J. Englot
AU - M. Bilgel
AU - L. L. Beason Held
AU - L. Ferrucci
AU - L. Cutting
AU - L. A. Barquero
AU - M. A. Darchangel
AU - T. Q. Nguyen
AU - K. L. Humphreys
AU - Y. Niu
AU - S. Vinci-Booher
AU - C. J. Cascio
AU - The HABS-HD Study Team
AU - Alzheimers Disease Neuroimaging Initiative
AU - The BIOCARD Study Team
AU - Z. Li
AU - D. Moyer
AU - S. N. Vandekar
AU - P. Zhang
AU - S. St-Onge
AU - S. Bedard
AU - J. Valosek
AU - B. De Leener
AU - J. Cohen-Adad
PY - 2026
DA - 2026/06/03
PB - bioRxiv
DO - 10.64898/2026.06.03.729823
UR - https://www.biorxiv.org/content/10.64898/2026.06.03.729823v2
AB - 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.
ER -