MR Spectroscopy of the Cervical Spinal Cord in Chronic Spinal Cord Injury.

Wyss PO; Huber E; Curt A; Kollias S; Freund P; Henning A

doi:10.1148/radiol.2018181037

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Journal article

MR Spectroscopy of the Cervical Spinal Cord in Chronic Spinal Cord Injury.

Wyss PO From the Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland (P.O.W., A.H.); Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland (P.O.W.); Max Planck Institute for Biological Cybernetics, Tuebingen, Germany (P.O.W., A.H.); Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland (E.H., A.C., P.F.); Institute of Neuroradiology, University Hospital, Zurich, Switzerland (S.K.); Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, England (P.F.); Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, England (P.F.); Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (P.F.); and Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany (A.H.).
Huber E From the Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland (P.O.W., A.H.); Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland (P.O.W.); Max Planck Institute for Biological Cybernetics, Tuebingen, Germany (P.O.W., A.H.); Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland (E.H., A.C., P.F.); Institute of Neuroradiology, University Hospital, Zurich, Switzerland (S.K.); Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, England (P.F.); Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, England (P.F.); Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (P.F.); and Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany (A.H.).
Curt A From the Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland (P.O.W., A.H.); Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland (P.O.W.); Max Planck Institute for Biological Cybernetics, Tuebingen, Germany (P.O.W., A.H.); Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland (E.H., A.C., P.F.); Institute of Neuroradiology, University Hospital, Zurich, Switzerland (S.K.); Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, England (P.F.); Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, England (P.F.); Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (P.F.); and Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany (A.H.).
Kollias S From the Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland (P.O.W., A.H.); Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland (P.O.W.); Max Planck Institute for Biological Cybernetics, Tuebingen, Germany (P.O.W., A.H.); Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland (E.H., A.C., P.F.); Institute of Neuroradiology, University Hospital, Zurich, Switzerland (S.K.); Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, England (P.F.); Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, England (P.F.); Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (P.F.); and Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany (A.H.).
Freund P From the Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland (P.O.W., A.H.); Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland (P.O.W.); Max Planck Institute for Biological Cybernetics, Tuebingen, Germany (P.O.W., A.H.); Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland (E.H., A.C., P.F.); Institute of Neuroradiology, University Hospital, Zurich, Switzerland (S.K.); Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, England (P.F.); Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, England (P.F.); Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (P.F.); and Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany (A.H.).
Henning A From the Institute for Biomedical Engineering, University and ETH Zurich, Gloriastrasse 35, CH-8092 Zurich, Switzerland (P.O.W., A.H.); Department of Radiology, Swiss Paraplegic Centre, Nottwil, Switzerland (P.O.W.); Max Planck Institute for Biological Cybernetics, Tuebingen, Germany (P.O.W., A.H.); Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland (E.H., A.C., P.F.); Institute of Neuroradiology, University Hospital, Zurich, Switzerland (S.K.); Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, England (P.F.); Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, England (P.F.); Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany (P.F.); and Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany (A.H.).

2019-01-30

Published in:

Radiology. - 2019

Magnetic Resonance Spectroscopy

English Purpose To investigate metabolic changes in chronic spinal cord injury (SCI) by applying MR spectroscopy in the cervical spinal cord. Materials and Methods Single-voxel short-echo spectroscopic data in study participants with chronic SCI and healthy control subjects were prospectively acquired in the cervical spinal cord at C2 above the level of injury between March 2016 and January 2017 and were compared between groups. Concentrations of total N-acetylaspartate (tNAA), myo-inositol (mI), total choline-containing compounds (tCho), creatine, and glutamine and glutamate complex were estimated from the acquired spectra. Participants were assessed with a comprehensive clinical evaluation investigating sensory and motor deficits. Correlation analysis was applied to investigate relationships between observed metabolic differences, lesion severity, and clinical outcome. Results There were 18 male study participants with chronic SCI (median age, 51 years; range, 30-68 years) and 11 male healthy control subjects (median age, 45 years; range, 30-67 years). At cervical level C2, tNAA/mI and tCho/mI ratios were lower in participants with SCI (tNAA/mI: -26%, P = .003; tCho/mI: -18%; P = .04) than in healthy control subjects. The magnitude of difference was greater with the severity of cord atrophy (tNAA/mI: R2 = 0.44, P = .003; tCho/mI: R2 = 0.166, P = .09). Smaller tissue bridges at the lesion site correlated with lower ratios of tNAA/mI (R2 = 0.69, P = .006) and tCho/mI (R2 = 0.51, P = .03) at the C2 level. Lower tNAA/mI and tCho/mI ratios were associated with worse sensory and motor outcomes (P < .05). Conclusion Supralesional metabolic alterations are observed in chronic spinal cord injury, likely reflecting neurodegeneration, demyelination, and astrocytic gliosis in the injured cervical cord. Lesion severity and greater clinical impairment are both linked to the biochemical changes in the atrophied cervical cord after spinal cord injury. © RSNA, 2019 Online supplemental material is available for this article. See also the editorial by Lin in this issue.

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