Width and neurophysiologic properties of tissue bridges predict recovery after cervical injury

Abstract

ObjectiveTo assess whether preserved dorsal and ventral midsagittal tissue bridges after traumatic cervical spinal cord injury (SCI) encode tract-specific electrophysiologic properties and are predictive of appropriate recovery.MethodsIn this longitudinal study, we retrospectively assessed MRI scans at 1 month after SCI that provided data on width and location (dorsal vs ventral) of midsagittal tissue bridges in 28 tetraplegic patients. Regression analysis assessed associations between midsagittal tissue bridges and motor- and sensory-specific electrophysiologic recordings and appropriate outcome measures at 12 months after SCI.ResultsGreater width of dorsal midsagittal tissue bridges at 1 month after SCI identified patients who were classified as being sensory incomplete at 12 months after SCI (p = 0.025), had shorter sensory evoked potential (SEP) latencies (r = −0.57, p = 0.016), and had greater SEP amplitudes (r = 0.61, p = 0.001). Greater width of dorsal tissue bridges predicted better light-touch score at 12 months (r = 0.40, p = 0.045) independently of baseline clinical score and ventral tissue bridges. Greater width of ventral midsagittal tissue bridges at 1 month identified patients who were classified as being motor incomplete at 12 months (p = 0.002), revealed shorter motor evoked potential (MEP) latencies (r = −0.54, p = 0.044), and had greater ratios of MEP amplitude to compound muscle action potential amplitude (r = 0.56, p = 0.005). Greater width of ventral tissue bridges predicted better lower extremity motor scores at 12 months (r = 0.41, p = 0.035) independently of baseline clinical score and dorsal tissue bridges.ConclusionMidsagittal tissue bridges, detectable early after SCI, underwrite tract-specific electrophysiologic communication and are predictors of appropriate sensorimotor recovery. Neuroimaging biomarkers of midsagittal tissue bridges may be integrated into the diagnostic workup, prediction of recovery, and patients' stratification in clinical trials.

Tissue bridges predict neuropathic pain emergence after spinal cord injury

“…Tissue bridge data from a small subset of the study population was previously reported in a different context. [9][10][11]…”

“…7 8 Preserved tissue bridges adjacent to the intramedullary lesion cavity, which can be identified in all patients with incomplete SCI, 9 are permissive for electrophysiological information flow and the size of which is predictive of functional recovery. [9][10][11] Importantly, NP below the level of injury develops over time. 12 This suggests that fractions of sensory pathways within preserved tissue bridges become active over time and may affect both ascending and descending modulatory systems.…”

“…This study aimed to explore the value of spared midsagittal tissue bridges (ventral and dorsal) derived from conventional T2-weighted (T2w) serial scans [9][10][11] in predicting the emergence and maintenance of SCI-related NP. Therefore, we investigated the relationships between the width of ventral and dorsal tissue bridges and pain intensity as well as its clinical characteristics.…”

Journal Club: Width and neurophysiologic properties of tissue bridges predict recovery after cervical injury

“…The study by Vallotton et al 5 retrospectively measured the width of dorsal and ventral tissue bridges on either side of the posttraumatic cyst and their correlation with long-term recovery. The authors show how MRI data taken at 1 month post SCI can be useful in determining relevant functional outcomes at 3 and 12 months post SCI.…”

“…Vallotton et al 5 show how measuring the individual widths of dorsal and ventral tissue bridges at 1 month following injury can be used to separately consider the long-term sensory or motor outcomes. This adds a further degree of detail for clinicians to take advantage of when trying to determine the likelihood and extent of recovery.…”