Predictive factors for irreversible motor paralysis following cervical spinal cord injury

Konomi, Tsunehiko; Suda, Kota; Ozaki, Masahiro; Harmon, Satoko Matsumoto; Komatsu, Miki; Iimoto, Seiji; Tsuji, Osahiko; Minami, Akio; Takahata, Masahiko; Iwasaki, Norimasa; Matsumoto, Morio; Nakamura, Masaya

doi:10.1038/s41393-020-0513-8

Cited by 7 publications

(5 citation statements)

References 57 publications

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“…SCI can be irreversible because the CNS has considerably low regenerative capacity [ 1 , 6 , 22 ]. After incomplete SCI, propriospinal circuits can play a role in restoring neuronal function, but regeneration is limited due to the unfavorable environment for cell to survive [ 23 – 26 ].…”

Section: Discussionmentioning

confidence: 99%

Neural stem/progenitor cells from adult canine cervical spinal cord have the potential to differentiate into neural lineage cells

Kim,

Son,

Lim

et al. 2023

BMC Vet Res

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Background • Neural stem/progenitor cells (NSPCs) are multipotent self-renewing cells that can be isolated from the brain or spinal cord. As they need to be isolated from neural tissues, it is difficult to study human NSPCs. To facilitate NSPC research, we attempted to isolate NSPCs from dogs, as dogs share the environment and having many similar diseases with humans. We collected and established primary cultures of ependymal and subependymal cells from the central canal of the cervical spinal cord of adult dogs. To isolate pure NSPCs, we employed the monolayer culture and selective medium culture methods. We further tested the ability of the NSPCs to form neurospheres (using the suspension culture method) and evaluated their differentiation potential. Results • The cells had the ability to grow as cultures for up to 10 passages; the growth curves of the cells at the 3rd, 6th, and 9th passages showed similar patterns. The NSPCs were able to grow as neurospheres as well as monolayers, and immunostaining at the 3rd, 6th, and 9th passages showed that these cells expressed NSPC markers such as nestin and SOX2 (immunofluorescent staining). Monolayer cultures of NSPCs at the 3rd, 6th, and 9th passages were cultured for approximately 14 days using a differentiation medium and were observed to successfully differentiate into neural lineage and glial cells (astrocytes, neurons, and oligodendrocytes) at all the three passages tested. Conclusion • It is feasible to isolate and propagate (up to at least 10 passages) canine cervical spinal cord-derived NSPCs with the capacity to differentiate into neuronal and glial cells. To the best of our knowledge this is the first study to successfully isolate, propagate, and differentiate canine NSPCs derived from cervical spinal cord in the adult canine, and we believe that these cells will contribute to the field of spinal cord regeneration in veterinary and comparative medicine.

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Section: Discussionmentioning

confidence: 99%

Neural stem/progenitor cells from adult canine cervical spinal cord have the potential to differentiate into neural lineage cells

Kim,

Son,

Lim

et al. 2023

BMC Vet Res

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“…11 Konomi and coworkers reported that the presence of intramedullary hemorrhage at initial MRI was a major risk factor for complete paralysis in the chronic phase. 12 Both have been reported as negative predictive factors.…”

Section: Discussionmentioning

confidence: 99%

“…All MRI studies were performed on a 3.0 T GE Discovery MR 750 (GE Healthcare). We assessed the longitudinal extent of intramedullary T2 hyperintensity, 22 23 maximum canal compromise (MCC), 13 24 maximum spinal cord compression (MSCC), 13 and presence of intramedullary-con ned lowintensity changes within diffuse high-intensity areas, which represents an intramedullary hemorrhage 12 (Fig. 1).…”

Section: Measurementsmentioning

confidence: 99%

“…Five grades (A, B, C, D, E) of the neurological outcome six months after injury were analyzed as primary outcome measures, based on previous studies indicating that the neurological recovery of CSCI reaches a plateau after six months. 12,28 With strati ed 5-fold cross-validation, patients were placed into 5 evenly populated groups and randomly assigned to a training and validation set in a 4:1 ratio. The training set was used to train the ML model, and the validation set was used to evaluate ML model performance.…”

Section: Algorithmsmentioning

confidence: 99%

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Efficacy of a machine learning-based approach in predicting neurological prognosis of cervical spinal cord injury patients following urgent surgery

Shimizu

Suda

Maki

et al. 2022

Preprint

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Prediction of the neurological prognosis of cervical spinal cord injury (CSCI) is useful for setting treatment goals. This study aimed to develop a machine learning (ML) model for predicting neurological outcomes of CSCI. We retrospectively analyzed 135 patients with CSCI who underwent surgery within 24 hours after injury. American Spinal Injury Association impairment scales (AIS; grades A to E) were analyzed 6 months after injury as primary outcome measures. A total of 33 features extracted from demographic variables, surgical factors, laboratory variables, neurological status, and radiological findings were analyzed. The multiclass ML model was created using Light GBM, XGBoost, and CatBoost. The accuracy, recall, precision, and F1 score were calculated for each classification model. We evaluated Shapley Additive Explanations (SHAP) values to determine the variables that contributed the most to the prediction models. Of the ML models used, CatBoost had the highest accuracy (0.807), recall (0.574), precision (0.808), and F1 score (0.622). AIS grade at admission, intramedullary hemorrhage, longitudinal extent of intramedullary T2 hyperintensity, total motor index score of the lower extremity, and HbA1c were identified as important features for the prediction model. The ML models successfully predicted neurological outcomes for five grades of AIS 6 months after injury.

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“…Numerous factors affect motor functions after SCI, and these factors have been analyzed in many studies [ 46 , 47 , 48 ]. Despite variations in estimates across studies, the generalized predictive outcome of ambulation and other functional activities largely depends on the severity of the injury and the scores of the related functional assessments [ 49 , 50 ].…”

Section: Discussionmentioning

confidence: 99%

MRI metrics at the epicenter of spinal cord injury are correlated with the stepping process in rhesus monkeys

et al. 2022

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Clinical evaluations of long-term outcomes in the early-stage spinal cord injury (SCI) focus on macroscopic motor performance and are limited in their prognostic precision. This study was designed to investigate the sensitivity of the magnetic resonance imaging (MRI) indexes to the data-driven gait process after SCI. Ten adult female rhesus monkeys were subjected to thoracic SCI. Kinematics-based gait examinations were performed at 1 (early stage) and 12 (chronic stage) months post-SCI. The proportion of stepping (PS) and gait stability (GS) were calculated as the outcome measures. MRI metrics, which were derived from structural imaging (spinal cord cross-sectional area, SCA) and diffusion tensor imaging (fractional anisotropy, FA; axial diffusivity, λ // ), were acquired in the early stage and compared with functional outcomes by using correlation analysis and stepwise multivariable linear regression. Residual tissue SCA at the injury epicenter and residual tissue FA/remote normal-like tissue FA were correlated with the early-stage PS and GS. The extent of lesion site λ // /residual tissue λ // in the early stage after SCI was correlated with the chronic-stage GS. The ratios of lesion site λ // to residual tissue λ // and early-stage GS were predictive of the improvement in the PS at follow-up. Similarly, the ratios of lesion site λ // to residual tissue λ // and early-stage PS best predicted chronic GS recovery. Our findings demonstrate the predictive power of MRI combined with the early data-driven gait indexes for long-term outcomes. Such an approach may help clinicians to predict functional recovery accurately.

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Predictive factors for irreversible motor paralysis following cervical spinal cord injury

Cited by 7 publications

References 57 publications

Neural stem/progenitor cells from adult canine cervical spinal cord have the potential to differentiate into neural lineage cells

Neural stem/progenitor cells from adult canine cervical spinal cord have the potential to differentiate into neural lineage cells

Efficacy of a machine learning-based approach in predicting neurological prognosis of cervical spinal cord injury patients following urgent surgery

MRI metrics at the epicenter of spinal cord injury are correlated with the stepping process in rhesus monkeys

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