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  Extent of cord pathology in the lumbosacral enlargement in non-traumatic versus traumatic spinal cord injury

David, G., Vallotton, K., Hupp, M., Curt, A., Freund, P., & Seif, M. (2022). Extent of cord pathology in the lumbosacral enlargement in non-traumatic versus traumatic spinal cord injury. Journal of Neurotrauma. doi:10.1089/neu.2021.0389.

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 Creators:
David, Gergely1, 2, Author
Vallotton, Kevin1, Author
Hupp, Markus1, Author
Curt, Armin1, Author
Freund, Patrick1, 3, 4, 5, Author           
Seif, Maryam1, 5, Author
Affiliations:
1Balgrist Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland, ou_persistent22              
2Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Germany, ou_persistent22              
3Department of Brain Repair & Rehabilitation, University College London, United Kingdom, ou_persistent22              
4Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London, United Kingdom, ou_persistent22              
5Department Neurophysics (Weiskopf), MPI for Human Cognitive and Brain Sciences, Max Planck Society, ou_2205649              

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Free keywords: Degenerative cervical myelopathy; Diffusion tensor imaging; Magnetic resonance imaging; Neurodegeneration; Traumatic spinal cord injury
 Abstract: This study compares remote neurodegenerative changes caudal to a cervical injury in degenerative cervical myelopathy (DCM; i.e., non-traumatic) and incomplete traumatic spinal cord injury (tSCI) patients, using magnetic resonance imaging (MRI)-based tissue area measurements and diffusion tensor imaging (DTI). Eighteen mild-to-moderate DCM patients with sensory impairments (modified Japanese Orthopedic score: 16.2 ± 1.9), 14 incomplete tetraplegic tSCI patients (American Spinal Injury Association Impairment Scale C and D), and 20 healthy controls were recruited. All participants received DTI and T2*-weighted scans in the lumbosacral enlargement (caudal to injury) and at C2/C3 (rostral to injury). MRI readouts included DTI metrics in the white matter (WM) columns and cross-sectional WM and gray matter area. One-way analysis of variance with Tukey's post hoc comparison (p < 0.05) was used to assess group differences. In the lumbosacral enlargement, compared with DCM, tSCI patients exhibited decreased fractional anisotropy in the lateral (tSCI vs. DCM, -11.9%, p = 0.007) and ventral WM column (-8.0%, p = 0.021), and showed a trend toward lower values in the dorsal column (-8.9%, p = 0.068). At C2/C3, compared with controls, fractional anisotropy was lower in both groups in the dorsal (DCM vs. controls, -7.9%, p = 0.024; tSCI vs. controls, -10.0%, p = 0.007) and in the lateral column (DCM: -6.2%, p = 0.039; tSCI: -13.3%, p < 0.001), while tSCI patients had lower fractional anisotropy than DCM patients in the lateral column (-7.6%, p = 0.029). WM areas were not different between patient groups but were lower compared with controls in the lumbosacral enlargement (DCM: -16.9%, p < 0.001; tSCI: -10.5%, p = 0.043) and at C2/C3 (DCM: -16.0%, p < 0.001; tSCI: -18.1%, p < 0.001). In conclusion, mild-to-moderate DCM and incomplete tSCI lead to similar degree of degeneration of the dorsal and lateral columns at C2/C3, but tSCI results in more widespread white matter damage in the lumbosacral enlargement. These remote changes are likely to contribute to the patients' impairment and recovery. DTI is a sensitive tool to assess remote pathological changes in DCM and tSCI patients.

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Language(s): eng - English
 Dates: 2022-02-08
 Publication Status: Published online
 Pages: -
 Publishing info: -
 Table of Contents: -
 Rev. Type: -
 Identifiers: DOI: 10.1089/neu.2021.0389
Other: online ahead of print
PMID: 35018824
 Degree: -

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Title: Journal of Neurotrauma
  Other : J. Neurotrauma
Source Genre: Journal
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Affiliations:
Publ. Info: New York, NY : M.A. Liebert
Pages: - Volume / Issue: - Sequence Number: - Start / End Page: - Identifier: ISSN: 0897-7151
CoNE: https://pure.mpg.de/cone/journals/resource/954925561573