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  Glutathione in the Pons Is Associated With Clinical Status Improvements in Subacute Spinal Cord Injury

Wyss, P., Richter, J., Zweers, P., Brust, A., Funk, C., Zoelch, N., et al. (2022). Glutathione in the Pons Is Associated With Clinical Status Improvements in Subacute Spinal Cord Injury. Investigative Radiology, Epub ahead. doi:10.1097/RLI.0000000000000905.

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 Creators:
Wyss, PO, Author
Richter, JK, Author
Zweers, P, Author
Brust, AK, Author
Funk, C, Author
Zoelch, N, Author
Vallesi, V, Author
Verma, RK, Author
Hock, A, Author
Berger, MF, Author
Scheel-Sailer, A, Author
Henning, A1, Author           
Affiliations:
1Research Group MR Spectroscopy and Ultra-High Field Methodology, Max Planck Institute for Biological Cybernetics, Max Planck Society, ou_2528692              

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 Abstract: Objectives In spinal cord injury (SCI), the primary mechanical injury is followed by secondary sequelae that develop over the subsequent months and manifests in biochemical, functional, and microstructural alterations, at the site of direct injury but also in the spinal cord tissue above and below the actual lesion site. Noninvasive magnetic resonance spectroscopy (MRS) can be used to assess biochemical modulation occurring in the secondary injury phase, in addition to and supporting conventional MRI, and might help predict and improve patient outcome. In this article, we aimed to examine the metabolic levels in the pons of subacute SCI by means of in vivo proton MRS at 3 T and explore the association to clinical scores. Materials and Methods In this prospective study, between November 2015 and February 2018, single-voxel short-echo MRS data were acquired in healthy controls and in SCI subjects in the pons once during rehabilitation. Besides the single-point MRS examination, in addition, in participants with SCI, the clinical status (ie, motor, light touch, and pinprick scores) was assessed twice: (1) around the MRS session (approximately 10 weeks postinjury) and (2) before discharge (at approximately 9 months postinjury). The group differences were assessed with Kruskal-Wallis test, the post hoc comparison was assessed with Wilcoxon rank sum test, and the clinical correlations were conducted with Spearman rank correlation test. Bayes factor calculations completed the statistical part providing relevant evidence values. Results Twenty healthy controls (median age, 50 years; interquartile range, 41–55 years; 18 men) and 18 subjects with traumatic SCI (median age, 50 years; interquartile range, 32–58 years; 16 men) are included. Group comparison showed an increase of total N-acetylaspartate and combined glutamate and glutamine levels in complete SCI and a reduction of total creatine in incomplete paraplegic SCI. The proton MRS-based glutathione levels at baseline correlate to the motor score improvement during rehabilitation in incomplete subacute SCI. Conclusions This exploratory study showed an association of the metabolite concentration of glutathione in the pons assessed at approximately 10 weeks after injury with the improvements of the motor score during the rehabilitation. Pontine glutathione levels in subjects with traumatic subacute incomplete SCI acquired remote from the injury site correlate to clinical score and might therefore be beneficial in the rehabilitation assessments.

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 Dates: 2022-08
 Publication Status: Published online
 Pages: -
 Publishing info: -
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 Rev. Type: -
 Identifiers: DOI: 10.1097/RLI.0000000000000905
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Title: Investigative Radiology
  Other : Invest. Radiol.
Source Genre: Journal
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Publ. Info: Philadelphia : J.B. Lippincott.
Pages: - Volume / Issue: Epub ahead Sequence Number: - Start / End Page: - Identifier: ISSN: 0020-9996
CoNE: https://pure.mpg.de/cone/journals/resource/954925408761