Subject-specific regional measures of water diffusion are associated with impairment in chronic spinal cord injury

This study investigates the use of diffusion tensor imaging (DTI) to assess spinal cord injury (SCI). DTI measures the movement of water molecules in the spinal cord, providing information about tissue integrity. The study aims to identify imaging markers that can indicate the severity of SCI. The researchers used a technique called DTI tractography to define specific regions of interest (ROIs) in the spinal cord based on individual injury patterns. This subject-specific approach aims to improve the accuracy of DTI measurements compared to traditional methods that average data over larger, less specific regions. The study found that DTI measurements from the region inferior to the injury epicenter (IRRI) showed the strongest correlation with clinical measures of impairment. This suggests that the IRRI region may be particularly sensitive to the effects of SCI, such as Wallerian degeneration.

• 1
  DTI indices obtained from the IRRI region showed the highest specificity to impairment, demonstrating their strong potential as biomarkers for the SCI severity.
• 2
  Total ISNCSCI score (ISNCSCI-tot; sum of ISNCSCI motor and sensory scores) was significantly (p<0.05) correlated with fractional anisotropy and axial and radial diffusivities.
• 3
  ISNCSCI-tot showed strongest correlation with indices measured from the region inferior to the injury epicenter (IRRI), the degree of which exceeded that of those measured from the entire cervical cord – suggesting contribution from Wallerian degeneration.