Journal article
Tracking the neurodegenerative gradient after spinal cord injury.
- Azzarito M Spinal Cord Injury Center Balgrist, University Hospital, Zurich, Switzerland. Electronic address: michela.azzarito@balgrist.ch.
- Seif M Spinal Cord Injury Center Balgrist, University Hospital, Zurich, Switzerland. Electronic address: Maryam.Seif@balgrist.ch.
- Kyathanahally S Spinal Cord Injury Center Balgrist, University Hospital, Zurich, Switzerland.
- Curt A Spinal Cord Injury Center Balgrist, University Hospital, Zurich, Switzerland. Electronic address: armin.curt@balgrist.ch.
- Freund P Spinal Cord Injury Center Balgrist, University Hospital, Zurich, Switzerland; Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany; Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, London, United Kingdom; Department of Neurology, University Hospital Zurich, Zurich, Switzerland. Electronic address: patrick.freund@balgrist.ch.
- 2020-03-08
Published in:
- NeuroImage. Clinical. - 2020
English
OBJECTIVE
To quantify neurodegenerative changes along the cervical spinal cord rostral to a spinal cord injury (SCI) by means of quantitative MRI (qMRI) and to determine its relationship with clinical impairment.
METHODS
Thirty chronic SCI patients (15 tetraplegics and 15 paraplegics) and 23 healthy controls underwent a high-resolution T1-weighted and myelin-sensitive magnetization transfer (MT) MRI. We assessed macro- and microstructural changes along the cervical cord from levels C1 to C4, calculating cross-sectional spinal cord area, its anterior-posterior and left-right width and myelin content (i.e. MT). Regression analysis determined associations between qMRI parameters and clinical impairment.
RESULTS
In SCI patients, cord area decreased by 2.67 mm2 (p = 0.004) and left-right width decreased by 0.35 mm (p = 0.002) per cervical cord level in the caudal direction when compared to the healthy controls. This gradient of neurodegeneration was greater in tetraplegic than paraplegics in the cross-sectional cervical cord area (by 3.28 mm2, p = 0.011), left-right width (by 0.36 mm, p = 0.03), and mean cord MT (by 0.13%, p = 0.04), but independant of lesion severity (p > 0.05). Higher lesion level was associated with greater magnitudes of neurodegeneration. Greater loss in myelin content in the dorsal columns and spinothalamic tract was associated with worse light touch (p = 0.016) and pin prick score (p = 0.024), respectively.
CONCLUSIONS
A gradient of neurodegeneration is evident in the cervical cord remote from a SCI. Tract-specific associations with appropriate clinical outcomes highlight that remote neurodegenerative changes are clinically eloquent. Monitoring the neurodegenerative gradient could be used to track treatment effects of regenerative and neuroprotective agents, both in trials targeting cervical and thoracic SCI patients.
To quantify neurodegenerative changes along the cervical spinal cord rostral to a spinal cord injury (SCI) by means of quantitative MRI (qMRI) and to determine its relationship with clinical impairment.
METHODS
Thirty chronic SCI patients (15 tetraplegics and 15 paraplegics) and 23 healthy controls underwent a high-resolution T1-weighted and myelin-sensitive magnetization transfer (MT) MRI. We assessed macro- and microstructural changes along the cervical cord from levels C1 to C4, calculating cross-sectional spinal cord area, its anterior-posterior and left-right width and myelin content (i.e. MT). Regression analysis determined associations between qMRI parameters and clinical impairment.
RESULTS
In SCI patients, cord area decreased by 2.67 mm2 (p = 0.004) and left-right width decreased by 0.35 mm (p = 0.002) per cervical cord level in the caudal direction when compared to the healthy controls. This gradient of neurodegeneration was greater in tetraplegic than paraplegics in the cross-sectional cervical cord area (by 3.28 mm2, p = 0.011), left-right width (by 0.36 mm, p = 0.03), and mean cord MT (by 0.13%, p = 0.04), but independant of lesion severity (p > 0.05). Higher lesion level was associated with greater magnitudes of neurodegeneration. Greater loss in myelin content in the dorsal columns and spinothalamic tract was associated with worse light touch (p = 0.016) and pin prick score (p = 0.024), respectively.
CONCLUSIONS
A gradient of neurodegeneration is evident in the cervical cord remote from a SCI. Tract-specific associations with appropriate clinical outcomes highlight that remote neurodegenerative changes are clinically eloquent. Monitoring the neurodegenerative gradient could be used to track treatment effects of regenerative and neuroprotective agents, both in trials targeting cervical and thoracic SCI patients.
- Language
-
- English
- Open access status
- gold
- Identifiers
-
- DOI 10.1016/j.nicl.2020.102221
- PMID 32145681
- Persistent URL
- https://sonar.ch/global/documents/94791
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