Journal of neurotrauma
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Journal of neurotrauma · Nov 2017
Diffusion Tensor Imaging Parameter Obtained During Acute Blunt Cervical Spinal Cord Injury in Predicting Long Term Outcome.
There are no reliable neuroimaging biomarkers to predict long-term outcome after spinal cord injury. This prospective longitudinal study evaluates diffusion tensor imaging (DTI) in predicting long-term outcome after cervical spinal cord injury (CSCI). We investigate the admission DTI parameters measured in 30 patients with CSCI, with 16 of them followed up to one year, and 15 volunteers serving as controls. ⋯ Further stepwise regression indicated that including AD (p = 0.0001) and presence of HC (p < 0.0001) in the regression model provided the best model fit for one year ISNCSCI (r2 = 0.93). The AD is a more specific parameter for axonal injury than radial diffusivity; this may indicate that axonal injury in the cord is the main factor affecting patient recovery. Our study demonstrates DTI measurement at the CSCI is a potential neuroimaging biomarker in predicting long-term neurological and functional outcome in blunt CSCI.
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Journal of neurotrauma · Nov 2017
Recurrent Neurologic Deterioration After Conservative Treatment for Acute Traumatic Central Cord Syndrome without bony injury: 17 operative cases report.
The mechanisms of late recurrent neurological deterioration after conservative treatment for acute traumatic central cord syndrome (ATCCS) remain unclear. Seventeen operative cases sustaining late recurrent neurological deterioration after conservative treatment for ATCCS were reviewed to investigate the mechanisms. The assessment of neurological status was based on International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). ⋯ All patients had a good neurological outcome at 6 month follow-up. Ruptures of ALLs, PLLs, and discs resulting in cervical instability and secondary compression on the spinal cord were important causes for recurrent neurological deterioration after conservative treatment for ATCCS. With timely spinal decompression after recurrent neurological deterioration, patients could achieve a good neurological outcome.
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Journal of neurotrauma · Nov 2017
The relationship between trans-lesional conduction, motor neuron pool excitability and motor function in dogs with incomplete recovery from severe spinal cord injury.
Spontaneous, acute, complete thoracolumbar spinal cord injury (TL-SCI) in dogs frequently results in permanent deficits modeling chronic paralysis in people. Recovery of walking without recovery of sensation has been interpreted in dogs as reflexive spinal walking. To evaluate this assumption, this study characterized the electrophysiological status of motor and sensory long tracts and local reflex circuitry in dogs with absent recovery of sensation after acute TL-SCI and correlated findings to gait scores. ⋯ H threshold in cases (mean, 3.2mA ±2.5) was lower than controls (mean, 7.9mA ±3.1; pa = 0.011) and was inversely associated with treadmill-based scores, SS, and RI (pa = 0.042, 0.043, respectively). The association between pelvic limb MEPs and gait scores supports the importance of descending influence on regaining walking after severe TL-SCI in dogs rather than just activation of spinal walking. The inverse association between H-reflex threshold and gait scores implies that increases in motor neuron pool excitability might also contribute to motor recovery.
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Journal of neurotrauma · Nov 2017
Application of the Rat Grimace Scale as a Marker of Supraspinal Pain Sensation after Cervical Spinal Cord Injury.
Experimental models of neuropathic pain (NP) typically rely on withdrawal responses to assess the presence of pain. Reflexive withdrawal responses to a stimulus are used to evaluate evoked pain and, as such, do not include the assessment of spontaneous NP nor evaluation of the affective and emotional consequences of pain in animal models. Additionally, withdrawal responses can be mediated by spinal cord reflexes and may not accurately indicate supraspinal pain sensation. ⋯ Rodents exhibited significantly higher RGS scores at week 5 post-injury as compared to baseline and laminectomy controls before the application of the stimulus, suggesting the presence of spontaneous NP. Additionally, there was a significant increase in RGS scores after the application of the acetone. These data suggest that the RGS can be used to assess spontaneous NP and determine the presence of evoked supraspinal pain sensation after experimental cervical SCI.
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Journal of neurotrauma · Nov 2017
Characterization of chronic axonal degeneration using diffusion tensor imaging in canine spinal cord injury: A quantitative analysis of DTI parameters according to histopathological differences.
Diffusion tensor imaging (DTI) is more sensitive than conventional magnetic resonance imaging (MRI) for the identification of axonal degeneration. However, no study to date has used DTI to evaluate the severity of axonal degeneration in canine spinal cord injury (SCI). Therefore, the aim of this study was to characterize multi-grade axonal degeneration (mild, moderate, and severe) in a canine model of spinal cord compression injury using DTI. ⋯ The severity of AxD demonstrated a negative linear correlation with fractional anisotropy and positive linear correlations with spherical index and radial diffusivity; additionally, positive U-shaped correlations were identified between the severity of AxD and mean diffusivity and axial diffusity (AD). These results demonstrate a potential clinical application for DTI in the noninvasive monitoring of histological changes post-SCI. DTI could be utilized for the early diagnosis and assessment of SCI and, ultimately, used to optimize the treatment and rehabilitation of SCI patients.