Brain White Matter Impairment in Patients with Spinal Cord Injury

Neural Plasticity, 2017 · DOI: 10.1155/2017/4671607 · Published: February 1, 2017

Spinal Cord Injury Neuroimaging Neurology

Simple Explanation

This study investigates how spinal cord injury (SCI) affects the white matter (WM) in the brain. Researchers used a method called tract-based spatial statistics (TBSS) to look at the integrity of the WM in fifteen patients with SCI. The study found that patients with SCI had significant decreases in WM in several brain regions compared to healthy individuals. These changes were observed irrespective of the injury severity. The researchers also found a correlation between the radial diffusivity (RD) of the left angular gyrus (AG) and total motor scores, suggesting that changes in this brain region are related to clinical performance after SCI.

Study Duration

Not specified

Participants

15 SCI patients and 15 healthy controls

Evidence Level

Not specified

Key Findings

1
SCI patients exhibited significant decreases in WM fractional anisotropy (FA) in several brain regions, including the left angular gyrus, right cerebellum, left precentral gyrus, left lateral occipital region, left superior longitudinal fasciculus, left supramarginal gyrus, and left postcentral gyrus.
2
No significant differences were found in diffusion indices between complete and incomplete SCI, suggesting that the severity of the injury may not significantly impact brain WM changes.
3
A significantly negative correlation was found between the increased radial diffusivity (RD) of the left angular gyrus and total motor scores, indicating a relationship between brain WM integrity and clinical performance.

Research Summary

The study aimed to determine if SCI could indirectly impair or reshape the white matter (WM) of the human brain and whether these changes correlate with injury severity, duration, or clinical performance. The findings showed significant decreases in WM fractional anisotropy (FA) in specific brain regions of SCI patients compared to healthy controls, with no significant differences observed between complete and incomplete SCI. The research also revealed a negative correlation between the radial diffusivity (RD) of the left angular gyrus and motor scores, suggesting that brain WM integrity can predict clinical performance.

Practical Implications

Rehabilitation Therapies

The affection of the left angular gyrus on rehabilitation therapies needs to be further researched in the future.

Prognosis Prediction

Diffusion indices have the potential to be used in investigations of secondary WM impairments and the prediction of the prognoses of SCI.

Understanding Degeneration

SCI can cause changes in the brain’s WM that are not limited to the sensorimotor system but includes brain areas without such direct connections.

Study Limitations

1
The study investigated WM changes in SCI patients with a very broad range of disease durations.
2
The injured spinal segments were heterogeneous.
3
The relative small sample size diminished the statistical power, particularly when we considered the CSCI and ISCI patients as separate groups.

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