Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.

<h4>Background</h4>Traumatic spinal cord injury (SCI) leads to disruption of axons and macroscopic tissue loss. Using diffusion tensor imaging (DTI), we assessed degeneration of the corticospinal tract (CST) in the cervical cord above a traumatic lesion and explored its relationship with...

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Main Authors: Patrick Freund, Torben Schneider, Zoltan Nagy, Chloe Hutton, Nikolaus Weiskopf, Karl Friston, Claudia A Wheeler-Kingshott, Alan J Thompson
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2012-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051729&type=printable
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author Patrick Freund
Torben Schneider
Zoltan Nagy
Chloe Hutton
Nikolaus Weiskopf
Karl Friston
Claudia A Wheeler-Kingshott
Alan J Thompson
author_facet Patrick Freund
Torben Schneider
Zoltan Nagy
Chloe Hutton
Nikolaus Weiskopf
Karl Friston
Claudia A Wheeler-Kingshott
Alan J Thompson
author_sort Patrick Freund
collection DOAJ
description <h4>Background</h4>Traumatic spinal cord injury (SCI) leads to disruption of axons and macroscopic tissue loss. Using diffusion tensor imaging (DTI), we assessed degeneration of the corticospinal tract (CST) in the cervical cord above a traumatic lesion and explored its relationship with cervical atrophy, remote axonal changes within the cranial CST and upper limb function.<h4>Methods</h4>Nine cervical injured volunteers with bilateral motor and sensory impairment and ten controls were studied. DTI of the cervical cord and brain provided measurements of fractional anisotropy (FA), while anatomical MRI assessed cross-sectional spinal cord area (i.e. cord atrophy). Spinal and central regions of interest (ROI) included the bilateral CST in the cervical cord and brain. Regression analysis identified correlations between spinal FA and cranial FA in the CST and disability.<h4>Results</h4>In individuals with SCI, FA was significantly lower in both CSTs throughout the cervical cord and brain when compared with controls (p≤0.05). Reduced FA of the cervical cord in patients with SCI was associated with smaller cord area (p = 0.002) and a lower FA of the cranial CST at the internal capsule level (p = 0.001). Lower FA in the cervical CST also correlated with impaired upper limb function, independent of cord area (p = 0.03).<h4>Conclusion</h4>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. This DTI protocol can be used in longitudinal assessment of microstructural changes immediately following injury and may be utilised to predict progression and monitor interventions aimed at promoting spinal cord repair.
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spelling doaj-art-d50a53f5d7894094aefc175fa84651482025-08-20T02:05:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032012-01-01712e5172910.1371/journal.pone.0051729Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.Patrick FreundTorben SchneiderZoltan NagyChloe HuttonNikolaus WeiskopfKarl FristonClaudia A Wheeler-KingshottAlan J Thompson<h4>Background</h4>Traumatic spinal cord injury (SCI) leads to disruption of axons and macroscopic tissue loss. Using diffusion tensor imaging (DTI), we assessed degeneration of the corticospinal tract (CST) in the cervical cord above a traumatic lesion and explored its relationship with cervical atrophy, remote axonal changes within the cranial CST and upper limb function.<h4>Methods</h4>Nine cervical injured volunteers with bilateral motor and sensory impairment and ten controls were studied. DTI of the cervical cord and brain provided measurements of fractional anisotropy (FA), while anatomical MRI assessed cross-sectional spinal cord area (i.e. cord atrophy). Spinal and central regions of interest (ROI) included the bilateral CST in the cervical cord and brain. Regression analysis identified correlations between spinal FA and cranial FA in the CST and disability.<h4>Results</h4>In individuals with SCI, FA was significantly lower in both CSTs throughout the cervical cord and brain when compared with controls (p≤0.05). Reduced FA of the cervical cord in patients with SCI was associated with smaller cord area (p = 0.002) and a lower FA of the cranial CST at the internal capsule level (p = 0.001). Lower FA in the cervical CST also correlated with impaired upper limb function, independent of cord area (p = 0.03).<h4>Conclusion</h4>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. This DTI protocol can be used in longitudinal assessment of microstructural changes immediately following injury and may be utilised to predict progression and monitor interventions aimed at promoting spinal cord repair.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051729&type=printable
spellingShingle Patrick Freund
Torben Schneider
Zoltan Nagy
Chloe Hutton
Nikolaus Weiskopf
Karl Friston
Claudia A Wheeler-Kingshott
Alan J Thompson
Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.
PLoS ONE
title Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.
title_full Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.
title_fullStr Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.
title_full_unstemmed Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.
title_short Degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment.
title_sort degeneration of the injured cervical cord is associated with remote changes in corticospinal tract integrity and upper limb impairment
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0051729&type=printable
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