Retrograde Wallerian degeneration of cranial corticospinal tracts in cervical spinal cord injury patients using diffusion tensor imaging

Guleria, Saurabh; Gupta, Rakesh K.; Saksena, Sona; Chandra, Anil; Srivastava, Rajeshwar Nath; Husain, Mazhar; Rathore, Ramkishore Singh; Narayana, Ponnada A.

doi:10.1002/jnr.21664

Cited by 60 publications

(41 citation statements)

References 43 publications

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“…Yamamoto et al 4 observed histological evidence of retrograde degeneration after SCI in supraspinal areas reaching as high as the pons. In a study by Guleria et al, 14 alterations in DTI metrics suggesting retrograde degeneration after SCI were shown along the corticospinal tract in the medulla, pons, midbrain and PLIC. Freund et al 15 observed a reduction in the FA in patients with SCI in the pyramids and the PLIC.…”

Section: Discussionmentioning

confidence: 92%

“…However, these studies consisted of relatively small samples and primarily included subjects with complete SCI. 5,14,15 The purpose of this study was to quantitatively assess the state of the cerebral white matter tracts in chronic traumatic SCI using DTI in a generalizable sample of patients with both clinically complete and incomplete SCI. We also investigated the association of DTI values with clinical neurological deficit.…”

Section: Introductionmentioning

confidence: 99%

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Clinical correlates of cerebral diffusion tensor imaging findings in chronic traumatic spinal cord injury

et al. 2014

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Study design: Prospective clinical case-control study. Objectives: The aim of this study was to use diffusion tensor imaging (DTI) to assess the state of cerebral white matter tracts after spinal cord injury (SCI). The DTI metrics were evaluated in relation to neurological deficits and to the size and level of the spinal cord lesions. Setting: Tampere University Hospital, Tampere, Finland. Methods: Thirty-four patients (n ¼ 34) with clinically complete and incomplete SCI were evaluated using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). DTI metrics (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) were calculated for multiple levels along the course of the corticospinal tract. The state of the spinal cord after injury was assessed using conventional magnetic resonance imaging (MRI). DTI parameters were compared with 40 orthopedically injured control subjects. Results: Statistically significant differences in the DTI values between patients and controls were detected in the posterior area of the centrum semiovale. In this area, the FA values were lower in the patients compared with controls (P ¼ 0.008). For patients with clinically complete injury, the difference was even more significant (P ¼ 0.0005). Motor and sensory scores of the ISNCSCI correlated positively with FA and negatively with ADC values of the centrum semiovale. A moderate association was observed between the macroscopic changes in the spinal cord and the DTI abnormalities in the centrum semiovale. Conclusion: In patients with chronic SCI, DTI changes can be observed in the cerebral white matter. These alterations are associated with the clinical state of the patients.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Clinical correlates of cerebral diffusion tensor imaging findings in chronic traumatic spinal cord injury

et al. 2014

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“…However, the translation of this technique for use in human SCI presents many challenges, including (1) the low signal-tonoise ratio and image resolution of human spinal MRI may prevent the accurate anatomical definition of the injured tissues; (2) the more challenging respiratory motion that complicates human spinal MRI, since the spine immobilization device used in rodents is not applicable in humans; (3) the severely degraded echo planar diffusion-weighted MRI quality due to severe susceptibility effects that prevent as high-quality spinal DTI in humans compared to that of rodents within a reasonable time period; and (4) the limited time frame to perform the acute MRI before stabilizing hardware placement in SCI patients. Despite these challenges, there have been some human spinal cord DTI reports in the literature (Ellingson et al, 2008a(Ellingson et al, , 2008bFacon et al, 2005;Guleria et al, 2008;Shanmuganathan et al, 2008;Yeatman et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Diffusion Tensor Imaging at 3 Hours after Traumatic Spinal Cord Injury Predicts Long-Term Locomotor Recovery

Kim

Loy

Wang

et al. 2010

Journal of Neurotrauma

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Accurate diagnosis of spinal cord injury (SCI) severity must be achieved before highly aggressive experimental therapies can be tested responsibly in the early phases after trauma. These studies demonstrate for the first time that axial diffusivity (ljj), derived from diffusion tensor imaging (DTI) within 3 h after SCI, accurately predicts long-term locomotor behavioral recovery in mice. Female C57BL=6 mice underwent sham laminectomy or graded contusive spinal cord injuries at the T9 vertebral level (5 groups, n ¼ 8 for each group). In-vivo DTI examinations were performed immediately after SCI. Longitudinal measurements of hindlimb locomotor recovery were obtained using the Basso mouse scale (BMS). Injured and spared regions of ventrolateral white matter (VLWM) were reliably separated in the hyperacute phase by threshold segmentation. Measurements of ljj were compared with histology in the hyperacute phase and 14 days after injury. The spared normal VLWM determined by hyperacute ljj and 14-day histology correlated well (r ¼ 0.95). A strong correlation between hindlimb locomotor function recovery and ljj-determined spared normal VLWM was also observed. The odds of significant locomotor recovery increased by 18% with each 1% increase in normal VLWM measured in the hyperacute phase (odds ratio ¼ 1.18, p ¼ 0.037). The capability of measuring subclinical changes in spinal cord physiology and murine genetic advantages offer an early window into the basic mechanisms of SCI that was not previously possible. Although significant obstacles must still be overcome to derive similar data in human patients, the path to clinical translation is foreseeable and achievable.

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“…It results in a loss of diffusion anisotropy (Batchelor, Atkinson et al 2003) and is reported in the cranial CST after cervical SCI (Guleria, Gupta et al 2008). …”

Section: Lumbar Enlargement (Le)mentioning

confidence: 95%

Chronic Cervical Spinal Cord Injury: DTI Correlates with Clinical and Electrophysiological Measures

Petersen

Wilm

Meyenburg

et al. 2012

Journal of Neurotrauma

118

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Diffusion tensor imaging (DTI) is rarely applied in spinal cord injury (SCI). The aim of this study was to correlate diffusion properties after SCI with electrophysiological and neurological measures. Nineteen traumatic cervical SCI subjects and 28 age-matched healthy subjects participated in this study. DTI data of the spinal cord were acquired with a Philips Achieva 3 T MR scanner using an outer volume suppressed, reduced field of view (FOV) acquisition with oblique slice excitation and a single-shot EPI readout. Neurological and electrophysiological measures, American Spinal Injury Association (ASIA) impairment scale scores, and motor (MEP) and somatosensory evoked potentials (SSEP) were assessed in SCI subjects. Fractional anisotropy (FA) values were decreased in the SCI subjects compared to the healthy subjects. In upper cervical segments, the decrease in FA was significant for the evaluation of the entire cross-sectional area of the spinal cord, and for corticospinal and sensory tracts. A decreasing trend was also found at the thoracic level for the corticospinal tracts. The decrease of DTI values correlated with the clinical completeness of SCI, and with SSEP amplitudes. The reduced DTI values seen in the SCI subjects are likely due to demyelination and axonal degeneration of spinal tracts, which are related to clinical and electrophysiological measures. A reduction in DTI values in regions remote from the injury site suggests their involvement with wallerian axonal degeneration. DTI can be used for the quantitative evaluation of the extent of spinal cord damage, and eventually to monitor the effects of future regeneration-inducing treatments. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. This article has been peer-reviewed and accepted for publication, but has yet to undergo copyediting and proof correction. The final published version may differ from this proof. Abstract

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Retrograde Wallerian degeneration of cranial corticospinal tracts in cervical spinal cord injury patients using diffusion tensor imaging

Cited by 60 publications

References 43 publications

Clinical correlates of cerebral diffusion tensor imaging findings in chronic traumatic spinal cord injury

Clinical correlates of cerebral diffusion tensor imaging findings in chronic traumatic spinal cord injury

Diffusion Tensor Imaging at 3 Hours after Traumatic Spinal Cord Injury Predicts Long-Term Locomotor Recovery

Chronic Cervical Spinal Cord Injury: DTI Correlates with Clinical and Electrophysiological Measures

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