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  Predictive value of midsagittal tissue bridges on functional recovery after spinal cord injury

Pfyffer, D., Vallotton, K., Curt, A., & Freund, P. (2021). Predictive value of midsagittal tissue bridges on functional recovery after spinal cord injury. Neurorehabilitation and Neural Repair, 35(1), 33-43. doi:10.1177/1545968320971787.

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 Creators:
Pfyffer, Dario1, Author
Vallotton, Kevin1, Author
Curt, Armin1, Author
Freund, Patrick1, 2, 3, Author           
Affiliations:
1Balgrist University Hospital, Zürich, Switzerland, ou_persistent22              
2Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, United Kingdom, ou_persistent22              
3Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              

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Free keywords: Decision trees; Magnetic resonance imaging; Prognosis; Recovery of function; Spinal cord injury
 Abstract: Background: The majority of patients with spinal cord injury (SCI) have anatomically incomplete lesions and present with preserved tissue bridges, yet their outcomes vary. Objective: To assess the predictive value of the anatomical location (ventral/dorsal) and width of preserved midsagittal tissue bridges for American Spinal Injury Association (ASIA) Impairment Scale (AIS) grade conversion and SCI patient stratification into recovery-specific subgroups. Methods: This retrospective longitudinal study includes 70 patients (56 men, age: 52.36 ± 18.58 years) with subacute (ie, 1 month) SCI (45 tetraplegics, 25 paraplegics), 1-month neuroimaging data, and 1-month and 12-month clinical data. One-month midsagittal T2-weighted scans were used to determine the location and width of tissue bridges. Their associations with functional outcomes were assessed using partial correlation and unbiased recursive partitioning conditional inference tree (URP-CTREE). Results: Fifty-seven (81.4%) of 70 patients had tissue bridges (2.53 ± 2.04 mm) at 1-month post-SCI. Larger ventral (P = .001, r = 0.511) and dorsal (P < .001, r = 0.546) tissue bridges were associated with higher AIS conversion rates 12 months post-SCI (n = 39). URP-CTREE analysis identified 1-month ventral tissue bridges as predictors of 12-month total motor scores (0.4 mm cutoff, P = .008), recovery of upper extremity motor scores at 12 months (1.82 mm cutoff, P = .002), 12-month pin-prick scores (1.4 mm cutoff, P = .018), and dorsal tissue bridges at 1 month as predictors of 12-month Spinal Cord Independence Measure scores (0.5 mm cutoff, P = .003). Conclusions: Midsagittal tissue bridges add predictive value to baseline clinical measures for post-SCI recovery. Based on tissue bridges' width, patients can be classified into subgroups of clinical recovery profiles. Midsagittal tissue bridges provide means to optimize patient stratification in clinical trials.

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Language(s): eng - English
 Dates: 2020-11-162021-01-01
 Publication Status: Published in print
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1177/1545968320971787
Other: ePub 2020
PMID: 33190619
 Degree: -

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Project name : -
Grant ID : WFL-CH-007/14
Funding program : -
Funding organization : Wings for Life
Project name : -
Grant ID : IRP-P158
Funding program : -
Funding organization : International Foundation for Research in Paraplegia
Project name : Horizon2020
Grant ID : 681094
Funding program : -
Funding organization : European Union
Project name : -
Grant ID : PCEFP3_181362/1
Funding program : -
Funding organization : SNF Eccellenza Professorial Fellowship
Project name : -
Grant ID : 091593/Z/10/Z
Funding program : -
Funding organization : Wellcome Trust

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Title: Neurorehabilitation and Neural Repair
Source Genre: Journal
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Affiliations:
Publ. Info: Thousand Oaks, CA, USA : Sage
Pages: - Volume / Issue: 35 (1) Sequence Number: - Start / End Page: 33 - 43 Identifier: ISSN: 0888-4390
CoNE: https://pure.mpg.de/cone/journals/resource/0888-4390