Single-cell transcriptomics reveals ependymal subtypes related to cytoskeleton dynamics as the core driver of syringomyelia pathological development

Syringomyelia is a common clinical lesion associated with cerebrospinal fluid flow abnormalities. By a reversible model with chronic extradural compression to mimic human canalicular syringomyelia, we explored the spatiotemporal patho-logical alterations during syrinx development. The most dynamic alterations were observed in ependymal cells (EPCs), oligodendrocyte lineage, and micro-glia, as a response to neuroinflammation. Among different cell types, EPC sub-types experienced obvious dynamic alterations, which were accompanied by ul-trastructural changes involving the ependymal cytoskeleton, cilia, and dynamic injury in parenchyma primarily around the central canal, corresponding to the sin-gle-cell transcripts. After effective decompression, the syrinx resolved with the recovery of pathological damage and overall neurological function, implying that for syringomyelia in the early stage, there was still endogenous repair poten-tial coexisting with immune microenvironment imbalance. Ependymal remodel-ing and cilia restoration might be important for better resolution of syringomye-lia and parenchymal injury recovery.

Automated summary

Syringomyelia is a common clinical lesion associated with cerebrospinal fluid flow abnormalities. In this study, a reversible model with chronic extradural compression was used to mimic human canalicular syringomyelia and explore the pathological alterations during syrinx development. Ependymal cells, oligodendrocyte lineage, and microglia showed the most dynamic changes in response to neuroinflammation. Effective decompression led to resolution of the syrinx and recovery of pathological damage and neurological function, suggesting the presence of endogenous repair potential in early-stage syringomyelia.