Diffusion tensor imaging at 3 hours after traumatic spinal cord injury predicts long-term locomotor recovery. J Neurotrauma 2010 Mar;27(3):587-98
Date
12/17/2009Pubmed ID
20001686Pubmed Central ID
PMC2867549DOI
10.1089/neu.2009.1063Scopus ID
2-s2.0-77950612951 97 CitationsAbstract
Accurate diagnosis of spinal cord injury (SCI) severity must be achieved before highly aggressive experimental therapies can be tested responsibly in the early phases after trauma. These studies demonstrate for the first time that axial diffusivity (lambda||), derived from diffusion tensor imaging (DTI) within 3 h after SCI, accurately predicts long-term locomotor behavioral recovery in mice. Female C57BL/6 mice underwent sham laminectomy or graded contusive spinal cord injuries at the T9 vertebral level (5 groups, n = 8 for each group). In-vivo DTI examinations were performed immediately after SCI. Longitudinal measurements of hindlimb locomotor recovery were obtained using the Basso mouse scale (BMS). Injured and spared regions of ventrolateral white matter (VLWM) were reliably separated in the hyperacute phase by threshold segmentation. Measurements of lambda|| were compared with histology in the hyperacute phase and 14 days after injury. The spared normal VLWM determined by hyperacute lambda|| and 14-day histology correlated well (r = 0.95). A strong correlation between hindlimb locomotor function recovery and lambda||-determined spared normal VLWM was also observed. The odds of significant locomotor recovery increased by 18% with each 1% increase in normal VLWM measured in the hyperacute phase (odds ratio = 1.18, p = 0.037). The capability of measuring subclinical changes in spinal cord physiology and murine genetic advantages offer an early window into the basic mechanisms of SCI that was not previously possible. Although significant obstacles must still be overcome to derive similar data in human patients, the path to clinical translation is foreseeable and achievable.
Author List
Kim JH, Loy DN, Wang Q, Budde MD, Schmidt RE, Trinkaus K, Song SKAuthor
Matthew Budde PhD Associate Professor in the Neurosurgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AnimalsDiffusion Magnetic Resonance Imaging
Disability Evaluation
Disease Models, Animal
Female
Gait Disorders, Neurologic
Hindlimb
Mice
Mice, Inbred C57BL
Motor Activity
Nerve Regeneration
Neuronal Plasticity
Paralysis
Predictive Value of Tests
Prognosis
Recovery of Function
Severity of Illness Index
Spinal Cord
Spinal Cord Injuries
Time
Time Factors
Wallerian Degeneration
