Journal article
Quantitative MRI of rostral spinal cord and brain regions is predictive of functional recovery in acute spinal cord injury.
- Seif M Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
- Curt A Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland.
- Thompson AJ Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK.
- Grabher P Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland.
- Weiskopf N Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, UK.
- Freund P Spinal Cord Injury Center Balgrist, University of Zurich, Switzerland; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, London, UK; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, UK. Electronic address: patrick.freund@balgrist.ch.
- 2018-09-04
Published in:
- NeuroImage. Clinical. - 2018
APW, anterior posterior width
Acute micro-structural changes
Brain and spinal cord atrophy
ISNCSCI, international standards for the neurological classification of spinal cord injury
LRW, left right width
MPM, multi-parameter mapping
MT, magnetization transfer
PD*, effective proton density
Quantitative neuroimaging
R1, longitudinal relaxation rate
R2*, effective transverse relaxation rate
ROI, region of interest
SCA, spinal cord area
SCI, spinal cord injury
SCIM, spinal cord independence measure
Spinal cord injury
VBCT, voxel based cortical thickness
VBM, voxel based morphometry
VBQ, voxel based quantification
Voxel-based morphometry and quantification
Acute Disease
Adolescent
Adult
Aged
Brain
Cervical Vertebrae
Female
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Predictive Value of Tests
Recovery of Function
Spinal Cord Injuries
Young Adult
English
Objective
To reveal the immediate extent of trauma-induced neurodegenerative changes rostral to the level of lesion and determine the predictive clinical value of quantitative MRI (qMRI) following acute spinal cord injury (SCI).
Methods
Twenty-four acute SCI patients and 23 healthy controls underwent a high-resolution T1-weighted protocol. Eighteen of those patients and 20 of controls additionally underwent a multi-parameter mapping (MPM) MRI protocol sensitive to the content of tissue structure, including myelin and iron. Patients were examined clinically at baseline, 2, 6, 12, and 24 months post-SCI. We assessed volume and microstructural changes in the spinal cord and brain using T1-weighted MRI, magnetization transfer (MT), longitudinal relaxation rate (R1), and effective transverse relaxation rate (R2*) maps. Regression analysis determined associations between acute qMRI parameters and recovery.
Results
At baseline, cord area and its anterior-posterior width were decreased in patients, whereas MT, R1, and R2* parameters remained unchanged in the cord. Within the cerebellum, volume decrease was paralleled by increases of MT and R2* parameters. Early grey matter changes were observed within the primary motor cortex and limbic system. Importantly, early volume and microstructural changes of the cord and cerebellum predicted functional recovery following injury.
Conclusions
Neurodegenerative changes rostral to the level of lesion occur early in SCI, with varying temporal and spatial dynamics. Early qMRI markers of spinal cord and cerebellum are predictive of functional recovery. These neuroimaging biomarkers may supplement clinical assessments and provide insights into the potential of therapeutic interventions to enhance neural plasticity.
To reveal the immediate extent of trauma-induced neurodegenerative changes rostral to the level of lesion and determine the predictive clinical value of quantitative MRI (qMRI) following acute spinal cord injury (SCI).
Methods
Twenty-four acute SCI patients and 23 healthy controls underwent a high-resolution T1-weighted protocol. Eighteen of those patients and 20 of controls additionally underwent a multi-parameter mapping (MPM) MRI protocol sensitive to the content of tissue structure, including myelin and iron. Patients were examined clinically at baseline, 2, 6, 12, and 24 months post-SCI. We assessed volume and microstructural changes in the spinal cord and brain using T1-weighted MRI, magnetization transfer (MT), longitudinal relaxation rate (R1), and effective transverse relaxation rate (R2*) maps. Regression analysis determined associations between acute qMRI parameters and recovery.
Results
At baseline, cord area and its anterior-posterior width were decreased in patients, whereas MT, R1, and R2* parameters remained unchanged in the cord. Within the cerebellum, volume decrease was paralleled by increases of MT and R2* parameters. Early grey matter changes were observed within the primary motor cortex and limbic system. Importantly, early volume and microstructural changes of the cord and cerebellum predicted functional recovery following injury.
Conclusions
Neurodegenerative changes rostral to the level of lesion occur early in SCI, with varying temporal and spatial dynamics. Early qMRI markers of spinal cord and cerebellum are predictive of functional recovery. These neuroimaging biomarkers may supplement clinical assessments and provide insights into the potential of therapeutic interventions to enhance neural plasticity.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1016/j.nicl.2018.08.026
- PMID 30175042
- Persistent URL
- https://sonar.ch/global/documents/5230
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