TY - JOUR
T1 - MR spectroscopy of the cervical spinal cord in chronic spinal cord injury
AU - Wyss, Patrik O.
AU - Huber, Eveline
AU - Curt, Armin
AU - Kollias, Spyros
AU - Freund, Patrick
AU - Henning, Anke
N1 - Funding Information:
Study funded by Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (143715), Hartmann Müller-Stiftung für Medizinische Forschung (2047), Universität Zürich (Clinical Research Priority Program Multiple Sclerosis), H2020 European Research Council (SYNAPLAST MR, grant no. 679927), and Wings for Life (WFL-CH-007/14).
Publisher Copyright:
© RSNA, 2019.
PY - 2019/4
Y1 - 2019/4
N2 - Purpose: To investigate metabolic changes in chronic spinal cord injury (SCI) by applying MR spectroscopy in the cervical spinal cord. Materials and Methods: Single-voxel short-echo spectroscopic data in study participants with chronic SCI and healthy control subjects were prospectively acquired in the cervical spinal cord at C2 above the level of injury between March 2016 and January 2017 and were compared between groups. Concentrations of total N-acetylaspartate (tNAA), myo-inositol (mI), total choline-containing compounds (tCho), creatine, and glutamine and glutamate complex were estimated from the acquired spectra. Participants were assessed with a comprehensive clinical evaluation investigating sensory and motor deficits. Correlation analysis was applied to investigate relationships between observed metabolic differences, lesion severity, and clinical outcome. Results: There were 18 male study participants with chronic SCI (median age, 51 years; range, 30–68 years) and 11 male healthy control subjects (median age, 45 years; range, 30–67 years). At cervical level C2, tNAA/mI and tCho/mI ratios were lower in participants with SCI (tNAA/mI: 226%, P = .003; tCho/mI: 218%; P = .04) than in healthy control subjects. The magnitude of difference was greater with the severity of cord atrophy (tNAA/mI: R2 = 0.44, P = .003; tCho/mI: R2 = 0.166, P = .09). Smaller tissue bridges at the lesion site correlated with lower ratios of tNAA/mI (R2 = 0.69, P = .006) and tCho/mI (R2 = 0.51, P = .03) at the C2 level. Lower tNAA/mI and tCho/mI ratios were associated with worse sensory and motor outcomes (P , .05). Conclusion: Supralesional metabolic alterations are observed in chronic spinal cord injury, likely reflecting neurodegeneration, demyelination, and astrocytic gliosis in the injured cervical cord. Lesion severity and greater clinical impairment are both linked to the biochemical changes in the atrophied cervical cord after spinal cord injury.
AB - Purpose: To investigate metabolic changes in chronic spinal cord injury (SCI) by applying MR spectroscopy in the cervical spinal cord. Materials and Methods: Single-voxel short-echo spectroscopic data in study participants with chronic SCI and healthy control subjects were prospectively acquired in the cervical spinal cord at C2 above the level of injury between March 2016 and January 2017 and were compared between groups. Concentrations of total N-acetylaspartate (tNAA), myo-inositol (mI), total choline-containing compounds (tCho), creatine, and glutamine and glutamate complex were estimated from the acquired spectra. Participants were assessed with a comprehensive clinical evaluation investigating sensory and motor deficits. Correlation analysis was applied to investigate relationships between observed metabolic differences, lesion severity, and clinical outcome. Results: There were 18 male study participants with chronic SCI (median age, 51 years; range, 30–68 years) and 11 male healthy control subjects (median age, 45 years; range, 30–67 years). At cervical level C2, tNAA/mI and tCho/mI ratios were lower in participants with SCI (tNAA/mI: 226%, P = .003; tCho/mI: 218%; P = .04) than in healthy control subjects. The magnitude of difference was greater with the severity of cord atrophy (tNAA/mI: R2 = 0.44, P = .003; tCho/mI: R2 = 0.166, P = .09). Smaller tissue bridges at the lesion site correlated with lower ratios of tNAA/mI (R2 = 0.69, P = .006) and tCho/mI (R2 = 0.51, P = .03) at the C2 level. Lower tNAA/mI and tCho/mI ratios were associated with worse sensory and motor outcomes (P , .05). Conclusion: Supralesional metabolic alterations are observed in chronic spinal cord injury, likely reflecting neurodegeneration, demyelination, and astrocytic gliosis in the injured cervical cord. Lesion severity and greater clinical impairment are both linked to the biochemical changes in the atrophied cervical cord after spinal cord injury.
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U2 - 10.1148/radiol.2018181037
DO - 10.1148/radiol.2018181037
M3 - Article
C2 - 30694162
AN - SCOPUS:85063616639
SN - 0033-8419
VL - 291
SP - 131
EP - 138
JO - RADIOLOGY
JF - RADIOLOGY
IS - 1
ER -