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  Tissue bridges predict recovery after traumatic and ischemic thoracic spinal cord injury

Pfyffer, D., Huber, E., Sutter, R., Curt, A., & Freund, P. (2019). Tissue bridges predict recovery after traumatic and ischemic thoracic spinal cord injury. Neurology, 93(16), e1550-e1560. doi:10.1212/WNL.0000000000008318.

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Item Permalink: http://hdl.handle.net/21.11116/0000-0005-BB20-4 Version Permalink: http://hdl.handle.net/21.11116/0000-0005-BB21-3
Genre: Journal Article

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Pfyffer_2019.pdf (Publisher version), 671KB
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 Creators:
Pfyffer, Dario1, Author
Huber, Eveline1, Author
Sutter, Reto1, Author
Curt, Armin1, Author
Freund, Patrick2, Author              
Affiliations:
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
2Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              

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 Abstract: Objective To investigate the spatiotemporal evolution and predictive properties of intramedullary damage and midsagittal tissue bridges at the epicenter of a thoracic spinal cord injury (SCI) using MRI. Methods We retrospectively assessed midsagittal T2-weighted scans from 25 patients with thoracic SCI (14 traumatic, 11 ischemic) at 1 month post-SCI. In 12 patients with SCI, linear mixed-effects models on serial MRI explored temporal trajectories of quantifiable lesion markers (area, length, and width) and tissue bridges. Using partial correlation analysis, we assessed associations between structural lesion characteristics at 1 month post-SCI and recovery at 1 year postinjury, adjusting for baseline clinical status, age, and sex. Results Lesion area decreased by 5.68 mm2 (p = 0.005), lesion length by 2.14 mm (p = 0.004), and lesion width by 0.13 mm (p = 0.004) per month. Width of tissue bridges increased by 0.06 mm (p = 0.019) per month, being similar in traumatic and ischemic SCI (p = 0.576). Smaller lesion area, length, width, and wider tissue bridges at 1 month post-SCI predicted better recovery at 1-year follow-up. Conclusions Over time, the immediate area of cord damage shrunk while the cystic cavity became demarcated. Adjacent to the cyst, midsagittal tissue bridges became visible. The width of tissue bridges at 1 month post-SCI predicted recovery at 1 year follow-up. Measures of lesion area and tissue bridges early after traumatic and ischemic thoracic SCI therefore allow characterizing the evolution of focal cord damage and are predictive of recovery in thoracic SCI. Thus, lesion extent and tissue bridges hold potential to improve diagnosis and patient stratification in interventional trials.

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Language(s): eng - English
 Dates: 2019-02-152019-05-152019-09-202019-10-15
 Publication Status: Published in print
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 Identifiers: DOI: 10.1212/WNL.0000000000008318
Other: Epub 2019
PMID: 31541012
PMC: PMC6815206
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Title: Neurology
Source Genre: Journal
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Publ. Info: Cleveland, Ohio [etc.] : Advanstar Communications [etc.]
Pages: - Volume / Issue: 93 (16) Sequence Number: - Start / End Page: e1550 - e1560 Identifier: ISSN: 0028-3878
CoNE: https://pure.mpg.de/cone/journals/resource/954925246073