Independent spinal cord atrophy measures correlate to motor and sensory deficits in individuals with spinal cord injury

Abstract

Study design: Cross-sectional descriptive analysis of magnetic resonance imaging (MRI) and clinical outcome. Objectives: The aim of this study was to present anatomically consistent and independent spinal cord atrophy measures based on standard MRI material and analyze their specific relations to sensory and motor outcome in individuals with chronic incomplete spinal cord injury (SCI). Setting: Danish study on human SCI. Methods: We included 19 individuals with chronic incomplete SCI and 16 healthy controls. Participants underwent MRI and a neurological examination including sensory testing for light touch and pinprick, and muscle strength. Antero-posterior width (APW), left-right width (LRW) and crosssectional spinal cord area (SCA) were extracted from MRI at the spinal level of C2. The angular variation of the spinal cord radius over the full circle was also extracted and compared with the clinical scores. Results: The motor score was correlated to LRW and the sensory scores were correlated to APW. The scores correlated also well with decreases in spinal cord radius in oblique angles in coherent and non-overlapping sectors for the sensory and motor qualities respectively. Conclusion: APW and LRW can be used to assess sensory and motor function independently. The finding is corresponding well with the respective locations of the main sensory and motor pathways.

Tracking trauma-induced structural and functional changes above the level of spinal cord injury

“…3 [67,68], as in human SCI [25,34]. In addition, cortical reorganization of S1 increased over time and correlated with the rostral, anterio-posterior diameter of the spinal cord indicating that a more severe SCI leads to greater cortical reorganization.…”

“…Importantly, clinically eloquent relationships between structural spinal and brain changes of the sensorimotor system have been demonstrated. Specifically, the amount of motor and sensory disability, as assessed by the international standards for the neurological classification of SPI protocol [32], was directly associated with the degree of spinal [27,33,34] and brain atrophy [29,35]. Moreover, a decrease in the left-right diameter of the cervical cord area correlated with the motor score and the anterior-posterior diameter with the sensory score [34], indicating tract-specific atrophy.…”

“…Specifically, the amount of motor and sensory disability, as assessed by the international standards for the neurological classification of SPI protocol [32], was directly associated with the degree of spinal [27,33,34] and brain atrophy [29,35]. Moreover, a decrease in the left-right diameter of the cervical cord area correlated with the motor score and the anterior-posterior diameter with the sensory score [34], indicating tract-specific atrophy. These clinically eloquent structural changes along the neuroaxis are suggestive of axonal degeneration and demyelination of the corticospinal tracts and the volume reduction at the cortical level reflect soma shrinkage of injured corticomotor neurons [36].…”

Supraspinal Control Predicts Locomotor Function and Forecasts Responsiveness to Training after Spinal Cord Injury

“…More generally, there is some evidence that magnetic resonance imaging (MRI)-based measures are correlated with impairment. Cross-sectional area of spinal tracts measured using MRI correlates with motor and sensory scores 147 and some diffusion tensor imaging have also been found to be correlated with motor and sensory function. 148 As yet, however, no studies have described the relationship between walking function and measures obtained via imaging.…”

Evaluation of Muscle Strength in Medullar Injury: A Literature Review

“…12,84,87 It also uses a six-point scale for MMT grading, but instead of isolated muscles, it evaluates muscle groups, which should also be determined by the examiner. 103 Another scale applied to MMT grading is that elaborated by the Medical Research Council, 23,50,79,86 as well as its variation, 83 96,99 Electronic search (n=495) Pubmed 12 MMT Daniels and Worthinghan Gomes-Osman; Field-Fote (2015) 13 Manual dynamometer Average of three repetitions 42 Isokinetic dynamometer three maximum voluntary contractions, with 3 to 6s of duration, and 1 minute of rest between them Sledziewski; Schaaf; Mount (2012) 43 MMT UEMS Alcobendas-Maestro et al (2012) 44 MMT LEMS 101 MMT Brunnstron e Dennen which grades strength on a scale of 0 to 5. It does not define the resistance that must be applied by the examiner at the time of the test, nor does it consider the range of motion developed.…”