Lateral Corticospinal Tract and Dorsal Column Damage: Predictive Relationships With Motor and Sensory Scores at Discharge From Acute Rehabilitation After Spinal Cord Injury

Smith, Andrew C.; O'Dell, Denise R; Albin, Stephanie; Berliner, Jeffrey; Dungan, David; Robinson, Eli; Elliott, James M.; Carballido‐Gamio, Julio; Stevens‐Lapsley, Jennifer E.; Weber, Kenneth A.

doi:10.1016/j.apmr.2021.07.792

Cited by 8 publications

(6 citation statements)

References 45 publications

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“…The main difference between nPT and aPT was gait instability in our study. Previous studies revealed that FCG, FCC, CST and SCT were associated with locomotion and gait ( Yasuda et al, 1993 ; Fink, 2013 ; Chalif et al, 2022 ; Smith et al, 2022 ), while there was no difference in these spinal tract parameters at C2 the level between nPT and aPT in the present study. Thus, we thought these spinal tracts microstructures at C2 level might not be correlated to the gait instability in CSM.…”

Section: Discussioncontrasting

confidence: 52%

“…Previous studies have shown that several spinal cord tracts are related to locomotion and gait, including the fasciculus gracilis (FCG), fasciculus cuneatus (FCC), lateral corticospinal tract (CST), and spinocerebellar tract (SCT) ( Yasuda et al, 1993 ; Fink, 2013 ; Chalif et al, 2022 ; Smith et al, 2022 ). Considering that the compression of the spinal cord may reduce the measurement accuracy ( Hopkins et al, 2018 ),we chose the spinal cord at the C2 level.…”

Section: Methodsmentioning

confidence: 99%

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Remodeling of the brain correlates with gait instability in cervical spondylotic myelopathy

Wang

Chang

et al. 2023

Front. Neurosci.

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IntroductionCervical spondylotic myelopathy (CSM) is a common form of non-traumatic spinal cord injury (SCI) and usually leads to remodeling of the brain and spinal cord. In CSM with gait instability, the remodeling of the brain and cervical spinal cord is unclear. We attempted to explore the remodeling of these patients’ brains and spinal cords, as well as the relationship between the remodeling of the brain and spinal cord and gait instability.MethodsAccording to the CSM patients’ gait, we divided patients into two groups: normal gait patients (nPT) and abnormal gait patients (aPT). Voxel-wise z-score transformation amplitude of low-frequency fluctuations (zALFF) and resting-state functional connectivity (rs-FC) were performed for estimating brain changes. Cross-sectional area (CSA) and fractional anisotropy (FA) of the spinal cord were computed by Spinal cord toolbox. Correlations of these measures and the modified Japanese Orthopedic Association (mJOA) score were analyzed.ResultsWe found that the zALFF of caudate nucleus in aPT was higher than that in healthy controls (HC) and lower than that in nPT. The zALFF of the right postcentral gyrus and paracentral lobule in HC was higher than those of aPT and nPT. Compared with the nPT, the aPT showed increased functional connectivity between the caudate nucleus and left angular gyrus, bilateral precuneus and bilateral posterior cingulate cortex (PCC), which constitute a vital section of the default mode network (DMN). No significantly different FA values or CSA of spinal tracts at the C2 level were observed between the HC, nPT and aPT groups. In CSM, the right paracentral lobule’s zALFF was negatively correlated with the FA value of fasciculus gracilis (FCG), and the right caudate zALFF was positively correlated with the FA value of the fasciculus cuneatus (FCC). The results showed that the functional connectivity between the right caudate nucleus and DMN was negatively correlated with the CSA of the lateral corticospinal tract (CST).DiscussionThe activation of the caudate nucleus and the strengthening functional connectivity between the caudate nucleus and DMN were associated with gait instability in CSM patients. Correlations between spinal cord and brain function might be related to the clinical symptoms in CSM.

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Section: Discussioncontrasting

confidence: 52%

Section: Methodsmentioning

confidence: 99%

Remodeling of the brain correlates with gait instability in cervical spondylotic myelopathy

Wang

Chang

et al. 2023

Front. Neurosci.

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“…White matter atrophy was observed in bilateral CSTs at the level of the brainstem, which was consistent with previous meta-analyses and VBM studies ( 22 , 35 , 48 – 50 ). The CST originates from the sensorimotor cortex and terminates in the motor neurons in the spinal cord, and it is involved in the voluntary movement of limbs and trunks ( 51 , 52 ). The volume of the CST decreased evidently within the first 40 days after injury ( 8 ), which corresponded to Wallerian degeneration in the spinal cord, including axonal degeneration and demyelination in animal models and postmortem human studies ( 53 – 55 ).…”

Section: Discussionmentioning

confidence: 99%

Brain morphology changes after spinal cord injury: A voxel-based meta-analysis

Chen²,

Jiang³

et al. 2022

Front. Neurol.

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ObjectivesSpinal cord injury (SCI) remodels the brain structure and alters brain function. To identify specific changes in brain gray matter volume (GMV) and white matter volume (WMV) following SCI, we conducted a voxel-based meta-analysis of whole-brain voxel-based morphometry (VBM) studies.MethodsWe performed a comprehensive literature search on VBM studies that compared SCI patients and healthy controls in PubMed, Web of Science and the China National Knowledge Infrastructure from 1980 to April 2022. Then, we conducted a voxel-based meta-analysis using seed-based d mapping with permutation of subject images (SDM-PSI). Meta-regression analysis was performed to identify the effects of clinical characteristics.ResultsOur study collected 20 studies with 22 GMV datasets and 15 WMV datasets, including 410 patients and 406 healthy controls. Compared with healthy controls, SCI patients showed significant GMV loss in the left insula and bilateral thalamus and significant WMV loss in the bilateral corticospinal tract (CST). Additionally, a higher motor score and pinprick score were positively related to greater GMV in the right postcentral gyrus, whereas a positive relationship was observed between the light touch score and the bilateral postcentral gyrus.ConclusionAtrophy in the thalamus and bilateral CST suggest that SCI may trigger neurodegeneration changes in the sensory and motor pathways. Furthermore, atrophy of the left insula may indicate depression and neuropathic pain in SCI patients. These indicators of structural abnormalities could serve as neuroimaging biomarkers for evaluating the prognosis and treatment effect, as well as for monitoring disease progression. The application of neuroimaging biomarkers in the brain for SCI may also lead to personalized treatment strategies.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021279716, identifier: CRD42021279716.

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“…MRI analysis details have been previously defined [ 27 , 42 , 43 ]. Briefly, all T2-weighted images were analyzed using the open-source Spinal Cord Toolbox (Version 5.1).…”

Section: Methodsmentioning

confidence: 99%

Multi-Site Spinal Cord Transcutaneous Stimulation Facilitates Upper Limb Sensory and Motor Recovery in Severe Cervical Spinal Cord Injury: A Case Study

Sharma,

Panta,

Ugiliweneza

et al. 2023

JCM

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Individuals with cervical spinal cord injury (SCI) rank regaining arm and hand function as their top rehabilitation priority post-injury. Cervical spinal cord transcutaneous stimulation (scTS) combined with activity-based recovery training (ABRT) is known to effectively facilitate upper extremity sensorimotor recovery in individuals with residual arm and hand function post SCI. However, scTS effectiveness in facilitating upper extremity recovery in individuals with severe SCI with minimal to no sensory and motor preservation below injury level remains largely unknown. We herein introduced a multimodal neuro-rehabilitative approach involving scTS targeting systematically identified various spinal segments combined with ABRT. We hypothesized that multi-site scTS combined with ABRT will effectively neuromodulate the spinal networks, resulting in improved integration of ascending and descending neural information required for sensory and motor recovery in individuals with severe cervical SCI. To test the hypothesis, a 53-year-old male (C2, AIS A, 8 years post-injury) received 60 ABRT sessions combined with continuous multi-site scTS. Post-training assessments revealed improved activation of previously paralyzed upper extremity muscles and sensory improvements over the dorsal and volar aspects of the hand. Most likely, altered spinal cord excitability and improved muscle activation and sensations resulted in observed sensorimotor recovery. However, despite promising neurophysiological evidence pertaining to motor re-activation, we did not observe visually appreciable functional recovery on obtained upper extremity motor assessments.

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Lateral Corticospinal Tract and Dorsal Column Damage: Predictive Relationships With Motor and Sensory Scores at Discharge From Acute Rehabilitation After Spinal Cord Injury

Cited by 8 publications

References 45 publications

Remodeling of the brain correlates with gait instability in cervical spondylotic myelopathy

Remodeling of the brain correlates with gait instability in cervical spondylotic myelopathy

Brain morphology changes after spinal cord injury: A voxel-based meta-analysis

Multi-Site Spinal Cord Transcutaneous Stimulation Facilitates Upper Limb Sensory and Motor Recovery in Severe Cervical Spinal Cord Injury: A Case Study

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