Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI

Cohen‐Adad, Julien; Mendili, M-M. El; Lehericy, Stéphane; Pf, Pradat; Blancho, Sophie; Rossignol, Serge; Benali, Habib

doi:10.1016/j.neuroimage.2010.11.089

Cited by 207 publications

(235 citation statements)

References 86 publications

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“…Recently, the relationship between spinal DTI values and ISNCSCI scores has been reported in chronic SCI patients. 12,27 To the best of our knowledge, this is the first study concerning cerebral sensory-motor white matter tracts in which the association of DTI values to the neurological deficit of patients with SCI has been demonstrated.…”

Section: Discussionmentioning

confidence: 90%

“…Few reports about the diffusion properties of the spinal cord in the chronic state of the injury have been published in the literature. [11][12][13] In those studies, DTI has been shown to estimate the total lesion load in the spinal cord better than conventional MRI. FA values have been proven to diminish in areas of the intact upper spinal cord after injury.…”

Section: Discussionmentioning

confidence: 99%

“…These results suggest secondary degeneration of the white matter tracts in the spinal cord. [11][12][13] Previously, abnormalities in DTI values of the cerebral corticospinal tract after SCI have also been reported. However, these studies consisted of relatively small samples and primarily included subjects with complete SCI.…”

Section: Introductionmentioning

confidence: 97%

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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: 90%

Section: Discussionmentioning

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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“…Reduced FA and increased MD have both been associated with loss of axonal count and myelin content. [14][15][16] Neuroprotective treatments 6,17 to improve functional independence and quality of life have entered clinical trials. 18 However, there is a need to detect and monitor subclinical trajectories prior to marked clinical impairment in tissue at risk (i.e.…”

Section: Introductionmentioning

confidence: 99%

Neurodegeneration in the Spinal Ventral Horn Prior to Motor Impairment in Cervical Spondylotic Myelopathy

Grabher

Mohammadi

Dávid

et al. 2017

Journal of Neurotrauma

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Remote grey matter pathology has been suggested rostral to the compression site in cervical spondylotic myelopathy (CSM). We used computational neuroimaging to assess in-vivo the extent and functional relevance of neurodegeneration in ventral and dorsal horns above the site of compression in the cervical cord of CSM patients. Twenty patients with CSM and eighteen healthy subjects underwent a high-resolution structural and diffusion MRI protocol at vertebra C2/C3. Patients received comprehensive clinical assessments. T2*-weighted data were used to segment the cross-sectional area of the grey matter into the ventral and dorsal horns. Within the ventral and dorsal horns mean diffusivity (MD) and fractional anisotropy (FA) derived from diffusion tensor imaging data determined the underlying microstructural integrity. Finally, the relationships between neurodegeneration occurring in the grey and white matter and clinical impairment were investigated. Patients suffered from mild to moderate CSM with mainly sensory impairment. The cross-sectional area of the ventral horns was not reduced (p=0.863) when compared to controls, but MD was increased (p=0.045). Greater increases in MD within the ventral horn were associated with white matter diffusivity changes (increased MD: p=0.013; decreased FA: p=0.028) within the lateral corticospinal tract. In contrast, dorsal horn cross-sectional area was reduced by 16.0% (p<0.001) without alterations in diffusivity indices when compared to controls. No associations between neurodegeneration and clinical impairment were evident. Grey matter atrophy and microstructural changes are evident remote to the compression site in CSM patients. Prior to marked motor impairment, pathophysiological changes in the ventral horns (e.g. motoneurons) related to white matter changes within the corticospinal tract. Thus, neuroimaging biomarkers of cord grey matter integrity reveal focal neurodegeneration prior to marked clinical impairment and thus could serve as predictors of ensuing impairment in CSM patients. 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. 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 paper 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. AbstractRemote grey matter pathology has been suggested rostral to the compression site in cervical spondylotic myelopathy (CSM). We therefore assessed neurodegeneration in the grey matter ventral and dorsal horns.Twenty patients with CSM and eighteen healthy subjects underwent a high-...

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“…FA has demonstrated moderate correlation with global and focal disability in dozens of studies involving various pathologies 3,[9][10][11][12][13][14] but has yet to achieve clinical uptake due to a lack of standardized/portable acquisition methods and cumbersome analysis techniques. MTR has also shown correlation with impairment in MS and spinal cord injury (SCI) studies, [15][16][17] but results have been inconsistent, in part due to T1 and frequency offset dependencies, and thus insufficient to drive clinical adoption. 3 At 3T or higher field strengths, T2*-weighted imaging of the SC provides high resolution and strong contrast between GM and WM, allowing segmentation between these structures and calculation of their CSA.…”

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confidence: 99%

A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio

Martín¹,

Leener

Cohen‐Adad

et al. 2017

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: T2*-weighted imaging provides sharp contrast between spinal cord GM and WM, allowing their segmentation and cross-sectional area measurement. Injured WM demonstrates T2*WI hyperintensity but requires normalization for quantitative use. We introduce T2*WI WM/GM signal-intensity ratio and compare it against cross-sectional area, the DTI metric fractional anisotropy, and magnetization transfer ratio in degenerative cervical myelopathy.

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Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI

Cited by 207 publications

References 86 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

Neurodegeneration in the Spinal Ventral Horn Prior to Motor Impairment in Cervical Spondylotic Myelopathy

A Novel MRI Biomarker of Spinal Cord White Matter Injury: T2*-Weighted White Matter to Gray Matter Signal Intensity Ratio

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