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Diffusion Tensor Magnetic Resonance Imaging in Chronic Spinal Cord Compression
Published on: May 7, 2019
Spinal cord spectroscopy and diffusion-based tractography to assess acute disability in multiple sclerosis
O Ciccarelli1, C A Wheeler-Kingshott, M A McLean
1Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK. o.ciccarelli@ion.ucl.ac.uk
Brain : a Journal of Neurology
|August 1, 2007
Summary
New MRI techniques reveal cervical cord damage in multiple sclerosis relapses. Quantitative MRI measures correlate with acute disability, suggesting potential for longitudinal studies and broader applications in spinal cord diseases.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- Multiple sclerosis (MS) requires advanced imaging to understand spinal cord pathology.
- Cervical cord involvement in MS relapses needs better assessment methods.
- Current understanding of MS spinal cord pathology is limited.
Purpose of the Study:
- To evaluate quantitative MRI measures in patients with cervical cord MS relapses.
- To compare MRI findings between MS patients and healthy controls.
- To correlate MRI measures with acute clinical disability.
Main Methods:
- Single-voxel (1)H-MR spectroscopy of the cervical cord (C1-C3) for metabolite quantification (tNAA, Cho, Cr, m-Ins).
- Diffusion-based tractography to assess major spinal cord pathways (cortico-spinal, spino-thalamic, fasciculus gracilis/cuneatus).
- Comparison of MRI measures (metabolite concentrations, fractional anisotropy, connectivity) between 14 MS patients and 13 controls, correlated with clinical scores (EDSS, HPT, 25-foot walk).
Main Results:
- MS patients exhibited lower total N-acetyl-aspartate (tNAA), reduced lateral cortico-spinal tract connectivity, and lower fractional anisotropy in lateral cortico-spinal and posterior tracts compared to controls.
- Significant correlations were found between Expanded Disability Status Scale (EDSS) and myo-Inositol (m-Ins), choline (Cho), creatine (Cr), and radial diffusivity of lateral cortico-spinal tracts.
- 9-hole peg test (HPT) correlated with Cr, radial diffusivity of lateral cortico-spinal tracts, and connectivity/fractional anisotropy of posterior and anterior tracts. m-Ins, Cr, tNAA, and posterior tract connectivity independently predicted EDSS and HPT scores.
Conclusions:
- MR spectroscopy and diffusion tractography provide sensitive measures of cervical spinal cord tissue damage in MS relapses.
- These quantitative MRI measures correlate significantly with acute clinical disability.
- The study suggests potential for longitudinal assessments and application of these techniques to other spinal cord diseases.
