Extrapyramidal plasticity predicts recovery after spinal cord injury

Scientific Reports, 2020 · DOI: 10.1038/s41598-020-70805-5 · Published: August 5, 2020

Spinal Cord Injury Neuroimaging Neurology

Simple Explanation

Spinal cord injury (SCI) leads to wide-spread neurodegeneration across the neuroaxis. We explored trajectories of surface morphology, demyelination and iron concentration within the basal ganglia-thalamic circuit over 2 years post-SCI. Baseline surface area expansions within the striatum (i.e. motor caudate) predicted better lower extremity motor score at 2-years. Extensive extrapyramidal neurodegenerative and reorganizational changes across the basal ganglia-thalamic circuitry occur early after SCI and progress over time; their magnitude being predictive of functional recovery. These results demonstrate a potential role of extrapyramidal plasticity during functional recovery after SCI.

Study Duration

2 years

Participants

17 SCI patients and 21 healthy controls

Evidence Level

Not specified

Key Findings

1
Surface area contracted in the motor (i.e. lower extremity) and pulvinar thalamus, and striatum; and expanded in the motor thalamus and striatum in patients compared to controls over 2-years.
2
In parallel, myelin-sensitive markers decreased in the thalamus, striatum, and globus pallidus, while iron-sensitive markers decreased within the left caudate.
3
Baseline surface area expansions within the striatum (i.e. motor caudate) predicted better lower extremity motor score at 2-years.

Research Summary

This study characterizes neurodegenerative and reorganizational changes across the basal ganglia-thalamic circuit after SCI using advanced neuroimaging measures, in vivo. We demonstrate a dynamic pattern of neurodegenerative and reorganizational changes in the basal ganglia-thalamus circuitry within the first 2-years post-SCI, its magnitude predicting functional recovery. This study provides evidence for progressive extrapyramidal macro- and microstructural changes after SCI, indicating large scale, trans-neuronal remodeling of primarily unaffected brain regions.

Practical Implications

Predicting Recovery

MRI based structural shape measures can be used for monitoring and predicting recovery after traumatic SCI.

Therapeutic Interventions

Neuroimaging biomarkers could be used to assess the influence of therapeutic interventions on training effects during rehabilitation.

Understanding Disease Mechanisms

The study's insights will enable better prediction of individual recovery trajectories and identify patients who could profit from targeted interventions.

Study Limitations

1
a histology-based atlas of the striatum and the globus pallidus is currently not available.
2
The upgrade of the MRI scanner might potentially be a confounding factor
3
the applied MPM protocol, consisting of MT, R1 and R2* measures, provides only indirect measures of myelin45 and iron46 but not specific to processes such as demyelination, degeneration and iron content.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury