White Matter Microstructure Alterations in Patients With Spinal Cord Injury Assessed by Diffusion Tensor Imaging

Front. Hum. Neurosci., 2019 · DOI: 10.3389/fnhum.2019.00011 · Published: February 12, 2019

Spinal Cord Injury Neurology Medical Imaging

Simple Explanation

Spinal cord injury (SCI) can lead to abnormalities in the brain's white matter (WM). This study investigates the differences in WM microstructure between individuals with paraplegia (thoracic SCI) and quadriplegia (cervical SCI). The study used diffusion tensor imaging (DTI) to measure the diffusion of water molecules in brain tissues, providing information about WM microstructure. Metrics like fractional anisotropy (FA) and mean diffusivity (MD) were analyzed. The findings suggest that SCI patients have damaged WM tracts in the brain, and the disruption is more pronounced in cervical SCI compared to thoracic SCI, particularly in the posterior thalamic radiation (PTR) region.

Study Duration

Not specified

Participants

22 SCI patients (11 cervical, 11 thoracic) and 22 healthy controls

Evidence Level

Not specified

Key Findings

1
Compared to controls, SCI patients showed decreased FA and increased MD and RD in several brain WM tracts, including the corpus callosum, superior longitudinal fasciculus, and corona radiata.
2
Cervical SCI patients had lower FA and higher RD in the left PTR than thoracic SCI patients, indicating more severe WM disruption in the cervical group.
3
Time since injury negatively correlated with FA in the right superior fronto-occipital fasciculus, suggesting a possible progression of WM pathology over time after SCI.

Research Summary

This study investigated white matter (WM) microstructure alterations in spinal cord injury (SCI) patients, comparing cervical and thoracic injury levels using diffusion tensor imaging (DTI). The results showed that SCI patients have altered brain WM compared to healthy controls, with decreased fractional anisotropy (FA) and increased mean diffusivity (MD) in several WM tracts. Cervical SCI patients exhibited more severe WM disruption in the posterior thalamic radiation (PTR) compared to thoracic SCI patients, suggesting that the level of injury impacts the extent of WM damage.

Practical Implications

Diagnostic Potential

DTI imaging may be a useful tool for identifying and monitoring neurodegeneration following SCI.

Targeted Therapies

Understanding the differences in WM disruption between cervical and thoracic SCI could lead to more targeted rehabilitation strategies.

Prognostic Value

The correlation between time since injury and WM integrity suggests that early intervention may be crucial in mitigating long-term WM damage.

Study Limitations

1
The study had a relatively small sample size in the SCI-subgroup comparison.
2
The SCI patients had a broad range of disease durations.
3
The exact histopathological processes leading to changes in DTI metrics over time are complex.

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