Assessing the state of chronic spinal cord injury using diffusion tensor imaging

Area of Science:

• Neuroimaging
• Spinal Cord Injury Research
• Biomedical Engineering

Background:

• Chronic traumatic spinal cord injury (SCI) leads to neurological disability.
• Conventional MRI may not detect subtle spinal cord pathology.
• Diffusion tensor imaging (DTI) offers advanced insights into white matter integrity.

Purpose of the Study:

• To quantify the association between cervical spinal cord DTI parameters and neurological disability in chronic SCI patients.
• To investigate DTI's ability to detect pathology not visible with conventional MRI.

Main Methods:

• Cervical spinal cord 3T MRI with DTI sequences in 28 chronic SCI patients and 40 controls.
• Calculation of DTI metrics: fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD).
• Clinical assessment using ISNCSCI and FIM motor subscale.

Main Results:

• Significantly lower FA and higher ADC/RD values in SCI patients compared to controls (p<0.00001).
• FA positively correlated with ISNCSCI motor/sensory scores and FIM motor subscale (p<0.01).
• DTI detected spinal cord pathology, likely secondary white matter degeneration, undetectable by conventional MRI.

Conclusions:

• DTI parameters are significantly altered in chronic SCI.
• Decreased FA correlates with poorer motor, sensory function, and reduced independence.
• DTI is a promising quantitative tool for clinical assessment in SCI.