Title
Demyelination and degeneration in the injured human spinal cord detected with diffusion and magnetization transfer MRI.
Abstract
Characterizing demyelination/degeneration of spinal pathways in traumatic spinal cord injured (SCI) patients is crucial for assessing the prognosis of functional rehabilitation. Novel techniques based on diffusion-weighted (DW) magnetic resonance imaging (MRI) and magnetization transfer (MT) imaging provide sensitive and specific markers of white matter pathology. In this paper we combined for the first time high angular resolution diffusion-weighted imaging (HARDI), MT imaging and atrophy measurements to evaluate the cervical spinal cord of fourteen SCI patients and age-matched controls. We used high in-plane resolution to delineate dorsal and ventrolateral pathways. Significant differences were detected between patients and controls in the normal-appearing white matter for fractional anisotropy (FA, p<0.0001), axial diffusivity (p<0.05), radial diffusivity (p<0.05), generalized fractional anisotropy (GFA, p<0.0001), magnetization transfer ratio (MTR, p<0.0001) and cord area (p<0.05). No significant difference was detected in mean diffusivity (p=0.41), T1-weighted (p=0.76) and T2-weighted (p=0.09) signals. MRI metrics were remarkably well correlated with clinical disability (Pearson's correlations, FA: p<0.01, GFA: p<0.01, radial diffusivity: p=0.01, MTR: p=0.04 and atrophy: p<0.01). Stepwise linear regressions showed that measures of MTR in the dorsal spinal cord predicted the sensory disability whereas measures of MTR in the ventro-lateral spinal cord predicted the motor disability (ASIA score). However, diffusion metrics were not specific to the sensorimotor scores. Due to the specificity of axial and radial diffusivity and MT measurements, results suggest the detection of demyelination and degeneration in SCI patients. Combining HARDI with MT imaging is a promising approach to gain specificity in characterizing spinal cord pathways in traumatic injury.
Year
DOI
Venue
2011
10.1016/j.neuroimage.2010.11.089
NeuroImage
Keywords
Field
DocType
SCI,DW,MT,HARDI,FA,GFA,MD,DTI,QBI,FOV
Spinal cord,Developmental psychology,Spinal cord injury,Neuroscience,Diffusion MRI,White matter,Fractional anisotropy,Psychology,Magnetization transfer,Atrophy,Pathology,Magnetic resonance imaging
Journal
Volume
Issue
ISSN
55
3
1053-8119
Citations 
PageRank 
References 
19
1.15
14
Authors
7
Name
Order
Citations
PageRank
Julien Cohen-Adad147229.21
M-M El Mendili2191.15
Stéphane Lehericy3736.15
P-F Pradat4191.15
S Blancho5191.15
S Rossignol6423.70
Habib Benali783768.94