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  Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment

Freund, P., Schneider, T., Nagy, Z., Hutton, C., Weiskopf, N., Friston, K., et al. (2012). Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment. PLoS One, 7(12): e51729. doi:10.1371/journal.pone.0051729.

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Item Permalink: http://hdl.handle.net/11858/00-001M-0000-0027-AEF8-1 Version Permalink: http://hdl.handle.net/21.11116/0000-0003-B070-7
Genre: Journal Article

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 Creators:
Freund, Patrick1, 2, 3, 4, Author
Schneider, Torben5, Author
Nagy, Zoltan2, Author
Hutton, Chloe2, Author
Weiskopf, Nikolaus2, Author              
Friston, Karl2, Author
Wheeler-Kingshott, Claudia A.5, Author
Thompson, Alan J.1, Author
Affiliations:
1Department of Brain Repair & Rehabilitation, Institute of Neurology, University College London, United Kingdom, ou_persistent22              
2Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom, ou_persistent22              
3Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, London, United Kingdom, ou_persistent22              
4Swiss Paraplegic Research (SPF), Nottwil, Switzerland, ou_persistent22              
5NMR Research Unit, Department of Neuroinflammation, Institute of Neurology, University College London, United Kingdom, ou_persistent22              

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 Abstract: BACKGROUND: Traumatic spinal cord injury (SCI) leads to disruption of axons and macroscopic tissue loss. Using diffusion tensor imaging (DTI), we assessed degeneration of the corticospinal tract (CST) in the cervical cord above a traumatic lesion and explored its relationship with cervical atrophy, remote axonal changes within the cranial CST and upper limb function. METHODS: Nine cervical injured volunteers with bilateral motor and sensory impairment and ten controls were studied. DTI of the cervical cord and brain provided measurements of fractional anisotropy (FA), while anatomical MRI assessed cross-sectional spinal cord area (i.e. cord atrophy). Spinal and central regions of interest (ROI) included the bilateral CST in the cervical cord and brain. Regression analysis identified correlations between spinal FA and cranial FA in the CST and disability. RESULTS: In individuals with SCI, FA was significantly lower in both CSTs throughout the cervical cord and brain when compared with controls (p≤0.05). Reduced FA of the cervical cord in patients with SCI was associated with smaller cord area (p = 0.002) and a lower FA of the cranial CST at the internal capsule level (p = 0.001). Lower FA in the cervical CST also correlated with impaired upper limb function, independent of cord area (p = 0.03). CONCLUSION: Axonal degeneration of the CST in the atrophic cervical cord, proximal to the site of injury, parallels cranial CST degeneration and is associated with disability. This DTI protocol can be used in longitudinal assessment of microstructural changes immediately following injury and may be utilised to predict progression and monitor interventions aimed at promoting spinal cord repair.

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Language(s): eng - English
 Dates: 2012-06-162012-11-052012-12-12
 Publication Status: Published online
 Pages: -
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 Table of Contents: -
 Rev. Method: Peer
 Identifiers: DOI: 10.1371/journal.pone.0051729
PMID: 23251612
PMC: PMC3520920
Other: Epub 2012
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Title: PLoS One
Source Genre: Journal
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Pages: - Volume / Issue: 7 (12) Sequence Number: e51729 Start / End Page: - Identifier: ISSN: 1932-6203
CoNE: https://pure.mpg.de/cone/journals/resource/1000000000277850