Emmenegger, Tim M;
Pfyffer, Dario;
Curt, Armin;
Schading-Sassenhausen, Simon;
Hupp, Markus;
Ashburner, John;
Friston, Karl;
... Freund, Patrick; + view all
(2024)
Longitudinal motor system changes from acute to chronic spinal cord injury.
European Journal of Neurology
, Article e16196. 10.1111/ene.16196.
(In press).
Preview |
Text
Longitudinal motor system changes from acute to chronic spinal cord injury.pdf - Published Version Download (13MB) | Preview |
Abstract
Background and purpose: In acute spinal cord injury (SCI), magnetic resonance imaging (MRI) reveals tissue bridges and neurodegeneration for 2 years. This 5-year study aims to track initial lesion changes, subsequent neurodegeneration, and their impact on recovery. // Methods: This prospective longitudinal study enrolled acute SCI patients and healthy controls who were assessed clinically—and by MRI—regularly from 3 days postinjury up to 60 months. We employed histologically cross-validated quantitative MRI sequences sensitive to volume, myelin, and iron changes, thereby reflecting indirectly processes of neurodegeneration and neuroinflammation. General linear models tracked lesion and remote changes in volume, myelin- and iron-sensitive magnetic resonance indices over 5 years. Associations between lesion, degeneration, and recovery (using the Spinal Cord Independence Measure [SCIM] questionnaire and the International Standards for Neurological Classification of Spinal Cord Injury total motor score) were assessed. // Results: Patients' motor scores improved by an average of 12.86 (95% confidence interval [CI] = 6.70–19.00) points, and SCIM by 26.08 (95% CI = 17.00–35.20) points. Within 3–28 days post-SCI, lesion size decreased by more than two-thirds (3 days: 302.52 ± 185.80 mm2, 28 days: 76.77 ± 88.62 mm2), revealing tissue bridges. Cervical cord and corticospinal tract volumes transiently increased in SCI patients by 5% and 3%, respectively, accompanied by cervical myelin decreases and iron increases. Over time, progressive atrophy was observed in both regions, which was linked to early lesion dynamics. Tissue bridges, reduced swelling, and myelin content decreases were predictive of long-term motor score recovery and improved SCIM score. // Conclusions: Studying acute changes and their impact on longer follow-up provides insights into SCI trajectory, highlighting the importance of acute intervention while indicating the potential to influence outcomes in the later stages.
| Type: | Article |
|---|---|
| Title: | Longitudinal motor system changes from acute to chronic spinal cord injury |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/ene.16196 |
| Publisher version: | https://doi.org/10.1111/ene.16196 |
| Language: | English |
| Additional information: | Copyright © 2024 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, https://creativecommons.org/licenses/by-nc-nd/4.0/, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
| Keywords: | Acute spinal cord injury; iron; lesion core; MRI; neurodegeneration |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Imaging Neuroscience |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10186149 |
Archive Staff Only
 |
View Item |
