Brain White Matter Abnormality Induced by Chronic Spinal Cord Injury in the Pediatric Population: A Preliminary Tract-based Spatial Statistic Study

2021 ◽  
Author(s):  
Joshua Fisher ◽  
Mahdi Alizadeh ◽  
Devon Middleton ◽  
Caio M. Matias ◽  
MJ Mulcahey ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
White Matter ◽  
International Standards ◽  
Slice Thickness ◽  
Medial Lemniscus ◽  
Single Shot ◽  
Brain White Matter ◽  
Severity Of Injury ◽  
Cord Injury

Objectives: Tract-based spatial statistics (TBSS) is a diffusion tensor imaging (DTI)–based processing technique that aims to improve the objectivity and interpretability of analysis of multisubject diffusion imaging studies. This study used TBSS to measure quantitative changes in brain white matter structures following spinal cord injury (SCI). Methods: Eighteen SCI subjects aged 8–20 years old (mean age, 16.5 years) were scanned using a conventional single-shot EPI DTI protocol using a 3.0T Siemens MR scanner. All participants underwent a complete International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination to determine the level and severity of injury. Five participants were classified as American Spinal Injury Association Impairment Scale (AIS) A, nine as AIS B, and four as AIS C/D. Imaging parameters used for data collection were as follows: 20 directions, b = 1000 s/mm2, voxel size = 1.8 mm × 1.8 mm, slice thickness = 5 mm, TE = 95 ms, TR = 4300 ms, slices = 30, TA = 4:45 min. To generate TBSS, nonparametric permutation tests were used for voxel-wise statistical analysis of the fractional anisotropy (FA) skeletons between AIS groups. A two-tailed t test was applied to extract voxels with significant differences at p < .05. Results: Notable significant changes occurred throughout the corticospinal, spinothalamic, and dorsal column/medial lemniscus tracts. Altered regions in the temporal, occipital, and parietal lobes were also identified. Conclusion: These results suggest that white matter structures are altered differently between people with different AIS classifications. TBSS has the potential to serve as a screening tool to identify white matter changes in regions of interest.

scholarly journals Traumatic Spondyloptosis: Neurological, Surgical, and Outcome Perspectives in a Tertiary Care Center

2021 ◽  
Author(s):  
Rahul Singh ◽  
Ravi Shankar Prasad ◽  
Ashvamedh Singh ◽  
Kulwant Singh ◽  
Anurag Sahu
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Sagittal Plane ◽  
Care Center ◽  
Tertiary Care ◽  
International Standards ◽  
Surgical Approaches ◽  
Severity Of Injury ◽  
Cord Injury

Abstract Objective To evaluate traumatic spondyloptosis cases for neurological, surgical, and outcome perspectives. Materials and Methods This retrospective study includes 17 patients of spondyloptosis admitted in our department between August 2016 and January 2020. Each patient was evaluated in terms of demographic profile, clinical presentation, duration of injury, mode of injury, associated injuries, level and type of spondyloptosis, spinal cord status, nociceptive and neuropathic pain severity, severity of injury based on International Standards for Neurological Classification of Spinal Cord Injury (ISNCSI) assessment, surgical approaches, complications, and outcome. Unpaired t- test and Chi-square test were used for statistical analysis. Values with p < 0.05 were considered statistically significant. Results Fall from height (58.8%) was the most common mode of injury. Most common level of spondyloptosis was T12–L1 (41.1%). Sagittal–plane spondyloptosis (76.5%) were more common than coronal–plane spondyloptosis (23.5%). Most common associated injury was musculoskeletal (64.7%). Neurological status of the patient at presentation (p = 0.0007) was significantly associated with outcome after 3 months of surgery/conservative management. Residual listhesis was present in 53.3% of patients postoperatively. Postoperative nociceptive pain (p = 0.0171) and neuropathic pain (0.0329) were significantly associated with residual listhesis. Duration of injury (p = 0.0228) was also significantly associated with postoperative residual listhesis. Conclusion Complete reduction of spondyloptosis should be the goal of surgery. Overall prognosis of spinal cord injury (SCI) due to traumatic spondyloptosis is poor.

scholarly journals Acute Traumatic and Ischemic Spinal Cord Injuries Have a Comparable Course of Recovery

2020 ◽  
Vol 34 (8) ◽  
pp. 723-732
Author(s):  
Giorgio Scivoletto ◽  
Monica Torre ◽  
Alessia Mammone ◽  
Doris D. Maier ◽  
Norbert Weidner ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Functional Recovery ◽  
Spinal Cord Injuries ◽  
International Standards ◽  
Walking Ability ◽  
Walk Test ◽  
Severity Of Injury ◽  
Cord Injury ◽  
Matching Procedure

Background. The relative rarity of ischemic compared with traumatic spinal cord injury (SCI) has limited a comparison of the outcomes of these conditions. Objective. To investigate the neurological and functional recovery of ischemic compared with traumatic acute SCI. Methods. Data were derived from the European Multicenter Study Spinal Cord Injury database. Patients with ischemic (iSCI) or traumatic SCI (tSCI), aged 18 years or older were evaluated at different time points from incidence: at about 1 month, 3 months, and 6 months. The neurological status was assessed at each time point by the International Standards for Neurological Classification of Spinal Cord Injury and the functional status by the Spinal Cord Independence Measure. Walking ability was evaluated by Walking Index for Spinal Cord Injury, 10-Meter Walk Test, and 6-Minute Walk Test. Because of the imbalances of the 2 groups in respect to size and lesion severity, a matching procedure according to age, neurological level, and severity of injury was performed. Outcomes evaluation was performed by means of a 2-way repeated-measures ANOVA. Results. The matching procedure resulted in 191 pairs. Both groups significantly improved from about 15 days after the lesion to 6 months. No differences were found in the course of neurological and functional recovery of iSCI compared with tSCI. Conclusions. This analysis from a representative cohort of participants revealed that from 15 days following the cord damage onward, the outcomes after iSCI and tSCI are comparable. This finding supports the potential enrolment of patients with acute iSCI into clinical trials from that point in time after the event and an evaluation up to 6 months afterward.

scholarly journals Brain White Matter Impairment in Patients with Spinal Cord Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Weimin Zheng ◽  
Qian Chen ◽  
Xin Chen ◽  
Lu Wan ◽  
Wen Qin ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
White Matter ◽  
Injury Severity ◽  
Clinical Performance ◽  
Angular Gyrus ◽  
Precentral Gyrus ◽  
Transneuronal Degeneration ◽  
Brain White Matter ◽  
Cord Injury

It remains unknown whether spinal cord injury (SCI) could indirectly impair or reshape the white matter (WM) of human brain and whether these changes are correlated with injury severity, duration, or clinical performance. We choose tract-based spatial statistics (TBSS) to investigate the possible changes in whole-brain white matter integrity and their associations with clinical variables in fifteen patients with SCI. Compared with the healthy controls, the patients exhibited significant decreases in WM fractional anisotropy (FA) in the left angular gyrus (AG), right cerebellum (CB), left precentral gyrus (PreCG), left lateral occipital region (LOC), left superior longitudinal fasciculus (SLF), left supramarginal gyrus (SMG), and left postcentral gyrus (PostCG) (p<0.01, TFCE corrected). No significant differences were found in all diffusion indices between the complete and incomplete SCI. However, significantly negative correlation was shown between the increased radial diffusivity (RD) of left AG and total motor scores (uncorrectedp<0.05). Our findings provide evidence that SCI can cause not only direct degeneration but also transneuronal degeneration of brain WM, and these changes may be irrespective of the injury severity. The affection of left AG on rehabilitation therapies need to be further researched in the future.

scholarly journals Statin use is associated with reduced motor recovery after spinal cord injury

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Erin M. Triplet ◽  
Isobel A. Scarisbrick
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Recovery ◽  
Motor Deficit ◽  
Historical Cohort ◽  
Cholesterol Lowering ◽  
Severity Of Injury ◽  
Cord Injury ◽  
The Impact ◽  
Statin Use

Abstract Study design We completed retrospective analysis of statin use in individuals with neurologically significant spinal cord injury in a historical cohort study. Objective Our objective was to establish the prevalence of cholesterol-lowering agent use following spinal cord injury (SCI) and to determine the impact on recovery of motor function. Setting Patients enrolled in the Rochester Epidemiology Project in Olmsted County, Minnesota, USA from 2005 to 2018 were included in analysis. Methods Exclusion criteria: age <18, comorbid neurological disease, prior neurological deficit, nontraumatic injury, survival <1 year, or lack of motor deficit. Demographics and cholesterol-lowering agent use in 83 individuals meeting all criteria were recorded. A total of 68/83 individuals were then assessed for change in function over the first 2 months after injury using the ISNCSCI motor subscore. Statistical comparison between control and statin groups was done by two-sided Chi-squared test or two-tailed Student’s t test. Generalized regression was performed to assess associations between independent variables and functional outcome. Results 30% of individuals with SCI had a prescription for a cholesterol-lowering agent. No significant differences were observed in severity of injury or demographic composition between groups. The change in motor subscore was reduced in the statin group compared to controls (p = 0.03, Mann–Whitney). Both severity of injury and statin were significant predictors of reduced motor recovery (p = 0.001, and p = 0.04, respectively). Conclusions Both severity of SCI and statins were significant predictors of reduced motor recovery. Additional investigation is needed to address potential impact of statin-therapy in the context of CNS injury and repair.

Contusion, dislocation, and distraction: primary hemorrhage and membrane permeability in distinct mechanisms of spinal cord injury

2007 ◽  
Vol 6 (3) ◽  
pp. 255-266 ◽  
Author(s):  
Anthony M. Choo ◽  
Jie Liu ◽  
Clarrie K. Lam ◽  
Marcel Dvorak ◽  
Wolfram Tetzlaff ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
White Matter ◽  
Animal Models ◽  
Membrane Permeability ◽  
High Speed ◽  
Test System ◽  
Fracture Dislocation ◽  
Sprague Dawley ◽  
Cord Injury

Object In experimental models of spinal cord injury (SCI) researchers have typically focused on contusion and transection injuries. Clinically, however, other injury mechanisms such as fracture–dislocation and distraction also frequently occur. The objective of the present study was to compare the primary damage in three clinically relevant animal models of SCI. Methods Contusion, fracture–dislocation, and flexion–distraction animal models of SCI were developed. To visualize traumatic increases in cellular membrane permeability, fluorescein–dextran was infused into the cerebrospi-nal fluid prior to injury. High-speed injuries (approaching 100 cm/second) were produced in the cervical spine of deeply anesthetized Sprague–Dawley rats (28 SCI and eight sham treated) with a novel multimechanism SCI test system. The animals were killed immediately thereafter so that the authors could characterize the primary injury in the gray and white matter. Sections stained with H & E showed that contusion and dislocation injuries resulted in similar central damage to the gray matter vasculature whereas no overt hemorrhage was detected following distraction. Contusion resulted in membrane disruption of neuronal somata and axons localized within 1 mm of the lesion epicenter. In contrast, membrane compromise in the dislocation and distraction models was observed to extend rostrally up to 5 mm, particularly in the ventral and lateral white matter tracts. Conclusions Given the pivotal nature of hemorrhagic necrosis and plasma membrane compromise in the initiation of downstream SCI pathomechanisms, the aforementioned differences suggest the presence of mechanism-specific injury regions, which may alter future clinical treatment paradigms.

scholarly journals Noninvasive diffusion tensor imaging of evolving white matter pathology in a mouse model of acute spinal cord injury

2007 ◽  
Vol 58 (2) ◽  
pp. 253-260 ◽  
Author(s):  
Joong Hee Kim ◽  
David N. Loy ◽  
Hsiao-Fang Liang ◽  
Kathryn Trinkaus ◽  
Robert E. Schmidt ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Mouse Model ◽  
Diffusion Tensor ◽  
Acute Spinal Cord Injury ◽  
Cord Injury ◽  
White Matter Pathology
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