Degeneration of the Injured Cervical Cord Is Associated with Remote Changes in Corticospinal Tract Integrity and Upper Limb Impairment

PLoS ONE, 2012 · DOI: 10.1371/journal.pone.0051729 · Published: December 12, 2012

Spinal Cord Injury Neuroimaging Neurology

Simple Explanation

Traumatic spinal cord injury (SCI) can cause damage to nerve fibers and loss of tissue. This study used a special type of MRI called diffusion tensor imaging (DTI) to look at the health of the corticospinal tract (CST), a major pathway for movement, in the spinal cord above the injury. The researchers also looked at whether there was any shrinkage of the spinal cord (atrophy) and whether there were changes in the CST in the brain. They wanted to see if these changes were related to how well the participants could use their upper limbs. The study found that in people with SCI, the CST in both the spinal cord and the brain showed signs of degeneration compared to healthy individuals. This degeneration in the spinal cord was linked to smaller cord size and changes in the CST in the brain. It was also related to problems with upper limb function.

Study Duration

Not specified

Participants

9 cervical injured volunteers and 10 controls

Evidence Level

Not specified

Key Findings

1
In individuals with SCI, FA was significantly lower in both CSTs throughout the cervical cord and brain when compared with controls.
2
Reduced FA of the cervical cord in patients with SCI was associated with smaller cord area and a lower FA of the cranial CST at the internal capsule level.
3
Lower FA in the cervical CST also correlated with impaired upper limb function, independent of cord area.

Research Summary

The study investigated the relationship between degeneration of the corticospinal tract (CST) in the cervical cord above a traumatic spinal cord injury (SCI) and its relationship with cervical atrophy, remote axonal changes within the cranial CST, and upper limb function. The study found that in individuals with SCI, FA was significantly lower in both CSTs throughout the cervical cord and brain when compared with controls, and reduced FA of the cervical cord was associated with smaller cord area and lower FA of the cranial CST. The study concludes that axonal degeneration of the CST in the atrophic cervical cord, proximal to the site of injury, parallels cranial CST degeneration and is associated with disability.

Practical Implications

Prognostic Tool

DTI protocol can be used in longitudinal assessment of microstructural changes immediately following injury.

Predicting Progression

The findings may be utilised to predict progression of spinal cord degeneration.

Monitoring Interventions

The DTI protocol may be used to monitor interventions aimed at promoting spinal cord repair.

Study Limitations

1
The spinal cord DTI data set of one patient was affected by motion artefacts and another patient had an incomplete DTI brain data set.
2
Small sample size limits the generalizability of the findings.
3
The cross-sectional study design does not allow for determining causality between CST degeneration and upper limb impairment.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury