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  Relationship between brainstem neurodegeneration and clinical impairment in traumatic spinal cord injury

Grabher, P., Blaiotta, C., Ashburner, J., & Freund, P. (2017). Relationship between brainstem neurodegeneration and clinical impairment in traumatic spinal cord injury. NeuroImage: Clinical, 15, 494-501. doi:10.1016/j.nicl.2017.05.026.

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Item Permalink: http://hdl.handle.net/11858/00-001M-0000-002D-FD67-2 Version Permalink: http://hdl.handle.net/21.11116/0000-0003-C7BA-B
Genre: Journal Article

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 Creators:
Grabher, Patrick1, Author
Blaiotta, Claudia2, Author
Ashburner, John2, Author
Freund, Patrick1, 2, 3, 4, Author              
Affiliations:
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
2Wellcome Trust Centre for Neuroimaging, University College London, United Kingdom, ou_persistent22              
3Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              
4Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              

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Free keywords: Spinal cord injuries; Brain stem; Atrophy; Periaqueductal grey; Pyramidal tracts; Red nucleus; Quantitative MRI; Structural MRI
 Abstract: Background: Brainstem networks are pivotal in sensory and motor function and in recovery following experimental spinal cord injury (SCI). Objective: To quantify neurodegeneration and its relation to clinical impairment in major brainstem pathways and nuclei in traumatic SCI. Methods: Quantitative MRI data of 30 chronic traumatic SCI patients (15 with tetraplegia and 15 with paraplegia) and 23 controls were acquired. Patients underwent a full neurological examination. We calculated quantitative myelin-sensitive (magnetisation transfer saturation (MT) and longitudinal relaxation rate (R1)) and iron-sensitive (effective transverse relaxation rate (R2*)) maps. We constructed brainstem tissue templates using a multivariate Gaussian mixture model and assessed volume loss, myelin reductions, and iron accumulation across the brainstem pathways (e.g. corticospinal tracts (CSTs) and medial lemniscus), and nuclei (e.g. red nucleus and periaqueductal grey (PAG)). The relationship between structural changes and clinical impairment were assessed using regression analysis. Results: Volume loss was detected in the CSTs and in the medial lemniscus. Myelin-sensitive MT and R1 were reduced in the PAG, the CSTs, the dorsal medulla and pons. No iron-sensitive changes in R2* were detected. Lower pinprick score related to more myelin reductions in the PAG, whereas lower functional independence was related to more myelin reductions in the vestibular and pontine nuclei. Conclusion: Neurodegeneration, indicated by volume loss and myelin reductions, is evident in major brainstem pathways and nuclei following traumatic SCI; the magnitude of these changes relating to clinical impairment. Thus, quantitative MRI protocols offer new targets, which may be used as neuroimaging biomarkers in treatment trials.

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Language(s): eng - English
 Dates: 2017-05-082016-12-012017-05-242017-06-01
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: Peer
 Identifiers: DOI: 10.1016/j.nicl.2017.05.026
PMID: 28649492
PMC: PMC5470571
Other: eCollection 2017
 Degree: -

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Project name : -
Grant ID : WFL-CH-007/14
Funding program : -
Funding organization : Wings for Life, Austria
Project name : NeuroRehab
Grant ID : -
Funding program : Clinical Research Priority Program (CRPP)
Funding organization : University Zurich
Project name : -
Grant ID : 091593/Z/10/Z
Funding program : -
Funding organization : Wellcome Trust

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Title: NeuroImage: Clinical
Source Genre: Journal
 Creator(s):
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Publ. Info: Elsevier
Pages: - Volume / Issue: 15 Sequence Number: - Start / End Page: 494 - 501 Identifier: ISSN: 2213-1582
CoNE: https://pure.mpg.de/cone/journals/resource/2213-1582