Width and neurophysiologic properties of tissue bridges predict recovery after cervical injury.
- Vallotton K From the Spinal Cord Injury Center (K.V., E.H., A.C., M.H., P.F.) and Department of Radiology (R.S.), Balgrist University Hospital; University of Zurich (K.V., E.H., A.C., M.H., P.F., R.S.), Switzerland; Wellcome Trust Centre for Neuroimaging (P.F.) and Department of Brain Repair and Rehabilitation (P.F.), UCL Institute of Neurology, University College London, UK; and Department of Neurophysics (P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Huber E From the Spinal Cord Injury Center (K.V., E.H., A.C., M.H., P.F.) and Department of Radiology (R.S.), Balgrist University Hospital; University of Zurich (K.V., E.H., A.C., M.H., P.F., R.S.), Switzerland; Wellcome Trust Centre for Neuroimaging (P.F.) and Department of Brain Repair and Rehabilitation (P.F.), UCL Institute of Neurology, University College London, UK; and Department of Neurophysics (P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Sutter R From the Spinal Cord Injury Center (K.V., E.H., A.C., M.H., P.F.) and Department of Radiology (R.S.), Balgrist University Hospital; University of Zurich (K.V., E.H., A.C., M.H., P.F., R.S.), Switzerland; Wellcome Trust Centre for Neuroimaging (P.F.) and Department of Brain Repair and Rehabilitation (P.F.), UCL Institute of Neurology, University College London, UK; and Department of Neurophysics (P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Curt A From the Spinal Cord Injury Center (K.V., E.H., A.C., M.H., P.F.) and Department of Radiology (R.S.), Balgrist University Hospital; University of Zurich (K.V., E.H., A.C., M.H., P.F., R.S.), Switzerland; Wellcome Trust Centre for Neuroimaging (P.F.) and Department of Brain Repair and Rehabilitation (P.F.), UCL Institute of Neurology, University College London, UK; and Department of Neurophysics (P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Hupp M From the Spinal Cord Injury Center (K.V., E.H., A.C., M.H., P.F.) and Department of Radiology (R.S.), Balgrist University Hospital; University of Zurich (K.V., E.H., A.C., M.H., P.F., R.S.), Switzerland; Wellcome Trust Centre for Neuroimaging (P.F.) and Department of Brain Repair and Rehabilitation (P.F.), UCL Institute of Neurology, University College London, UK; and Department of Neurophysics (P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Freund P From the Spinal Cord Injury Center (K.V., E.H., A.C., M.H., P.F.) and Department of Radiology (R.S.), Balgrist University Hospital; University of Zurich (K.V., E.H., A.C., M.H., P.F., R.S.), Switzerland; Wellcome Trust Centre for Neuroimaging (P.F.) and Department of Brain Repair and Rehabilitation (P.F.), UCL Institute of Neurology, University College London, UK; and Department of Neurophysics (P.F.), Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany. Patrick.Freund@Balgrist.ch.
- 2019-05-17
Published in:
- Neurology. - 2019
Adult
Aged
Cervical Cord
Cervical Vertebrae
Evoked Potentials, Motor
Evoked Potentials, Somatosensory
Female
Humans
Longitudinal Studies
Magnetic Resonance Imaging
Male
Middle Aged
Neck Injuries
Prognosis
Quadriplegia
Recovery of Function
Spinal Cord
Spinal Cord Injuries
Young Adult
English
OBJECTIVE
To assess whether preserved dorsal and ventral midsagittal tissue bridges after traumatic cervical spinal cord injury (SCI) encode tract-specific electrophysiologic properties and are predictive of appropriate recovery.
METHODS
In this longitudinal study, we retrospectively assessed MRI scans at 1 month after SCI that provided data on width and location (dorsal vs ventral) of midsagittal tissue bridges in 28 tetraplegic patients. Regression analysis assessed associations between midsagittal tissue bridges and motor- and sensory-specific electrophysiologic recordings and appropriate outcome measures at 12 months after SCI.
RESULTS
Greater width of dorsal midsagittal tissue bridges at 1 month after SCI identified patients who were classified as being sensory incomplete at 12 months after SCI (p = 0.025), had shorter sensory evoked potential (SEP) latencies (r = -0.57, p = 0.016), and had greater SEP amplitudes (r = 0.61, p = 0.001). Greater width of dorsal tissue bridges predicted better light-touch score at 12 months (r = 0.40, p = 0.045) independently of baseline clinical score and ventral tissue bridges. Greater width of ventral midsagittal tissue bridges at 1 month identified patients who were classified as being motor incomplete at 12 months (p = 0.002), revealed shorter motor evoked potential (MEP) latencies (r = -0.54, p = 0.044), and had greater ratios of MEP amplitude to compound muscle action potential amplitude (r = 0.56, p = 0.005). Greater width of ventral tissue bridges predicted better lower extremity motor scores at 12 months (r = 0.41, p = 0.035) independently of baseline clinical score and dorsal tissue bridges.
CONCLUSION
Midsagittal tissue bridges, detectable early after SCI, underwrite tract-specific electrophysiologic communication and are predictors of appropriate sensorimotor recovery. Neuroimaging biomarkers of midsagittal tissue bridges may be integrated into the diagnostic workup, prediction of recovery, and patients' stratification in clinical trials.
To assess whether preserved dorsal and ventral midsagittal tissue bridges after traumatic cervical spinal cord injury (SCI) encode tract-specific electrophysiologic properties and are predictive of appropriate recovery.
METHODS
In this longitudinal study, we retrospectively assessed MRI scans at 1 month after SCI that provided data on width and location (dorsal vs ventral) of midsagittal tissue bridges in 28 tetraplegic patients. Regression analysis assessed associations between midsagittal tissue bridges and motor- and sensory-specific electrophysiologic recordings and appropriate outcome measures at 12 months after SCI.
RESULTS
Greater width of dorsal midsagittal tissue bridges at 1 month after SCI identified patients who were classified as being sensory incomplete at 12 months after SCI (p = 0.025), had shorter sensory evoked potential (SEP) latencies (r = -0.57, p = 0.016), and had greater SEP amplitudes (r = 0.61, p = 0.001). Greater width of dorsal tissue bridges predicted better light-touch score at 12 months (r = 0.40, p = 0.045) independently of baseline clinical score and ventral tissue bridges. Greater width of ventral midsagittal tissue bridges at 1 month identified patients who were classified as being motor incomplete at 12 months (p = 0.002), revealed shorter motor evoked potential (MEP) latencies (r = -0.54, p = 0.044), and had greater ratios of MEP amplitude to compound muscle action potential amplitude (r = 0.56, p = 0.005). Greater width of ventral tissue bridges predicted better lower extremity motor scores at 12 months (r = 0.41, p = 0.035) independently of baseline clinical score and dorsal tissue bridges.
CONCLUSION
Midsagittal tissue bridges, detectable early after SCI, underwrite tract-specific electrophysiologic communication and are predictors of appropriate sensorimotor recovery. Neuroimaging biomarkers of midsagittal tissue bridges may be integrated into the diagnostic workup, prediction of recovery, and patients' stratification in clinical trials.
- Language
-
- English
- Open access status
- hybrid
- Identifiers
-
- DOI 10.1212/WNL.0000000000007642
- PMID 31092621
- Persistent URL
- https://sonar.ch/global/documents/3806
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