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Clinical correlates of high cervical fractional anisotropy in acute cervical spinal cord injury. World Neurosurg 2015 May;83(5):824-8

Date

09/24/2013

Pubmed ID

24055569

DOI

10.1016/j.wneu.2013.09.017

Scopus ID

2-s2.0-84929513579   28 Citations

Abstract

OBJECTIVE: Fractional anisotropy (FA) of the high cervical cord (C1-C2), rostral to the injury site, correlates with upper limb function in patients with chronic cervical spinal cord injury (SCI). In acute cervical SCI, this relationship has not been investigated. The objective of this study was to identify functional correlates of FA of the high cervical cord in a series of patients with acute cervical SCI.

METHODS: Traumatic cervical SCI patients who underwent presurgical cervical spine diffusion tensor imaging at our institution were reviewed for this study. FA of the whole cord as well as the lateral corticospinal tracts (CSTs) was calculated on axial images from C1-C2. Upper limb motor (C5-T1) and sensory (C2-T1) function scores were extracted from the admission American Spinal Injury Association (ASIA) examinations. Correlation analysis for FA with ASIA examinations was performed using a Pearson correlation.

RESULTS: Twelve subjects (9 men, 3 women; mean age 54.7 ± 4.0 years) underwent cervical spine diffusion tensor imaging at a mean duration of 3.6 ± 0.9 days postinjury. No patient had cord compression or intramedullary T2-weighted hyperintensities within the C1-C2 segments. FA correlated with upper limb motor score (whole cord: r = 0.59, P = .04; CST: 0.67, P = .01) and the ASIA grade (whole cord: r = 0.61, P = .03; CST: r = 0.71, P = .009). No correlation was found between FA and sensory scores.

CONCLUSIONS: FA of the whole cervical cord as well as the CST, rostral to the injury site, is associated with preserved upper limb motor function as well as superior ASIA grades after acute cervical SCI. FA of the high cervical cord is a potential biomarker of neural injury after acute cervical SCI.

Author List

Vedantam A, Eckardt G, Wang MC, Schmit BD, Kurpad SN

Authors

Shekar N. Kurpad MD, PhD Chair, Professor in the Neurosurgery department at Medical College of Wisconsin
Brian Schmit PhD Professor in the Biomedical Engineering department at Marquette University
Marjorie Wang MD Chief, Professor in the Neurosurgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Acute Disease
Adult
Aged
Anisotropy
Cervical Cord
Diffusion Tensor Imaging
Female
Humans
Male
Middle Aged
Movement
Neurologic Examination
Pyramidal Tracts
Sensation
Spinal Cord Injuries
Upper Extremity
Young Adult