Distinct Patterns of Cortical Morphology Reorganization in Children with Complete and Incomplete Spinal Cord...

Area of Science:

• Neuroscience
• Radiology
• Pediatric Neurology

Background:

• Pediatric spinal cord injury (SCI) leads to significant neuroplasticity in the developing brain.
• Understanding cortical remodeling differences between complete SCI (CSCI) and incomplete SCI (ICSCI) is crucial but poorly understood.

Purpose of the Study:

• To investigate and compare cortical morphological alterations in pediatric patients with CSCI and ICSCI using high-resolution structural MRI.
• To identify specific patterns of brain reorganization associated with different severities of pediatric SCI.

Main Methods:

• Structural MRI was used to analyze cortical surface area, thickness, and volume in 72 pediatric SCI patients (38 CSCI, 34 ICSCI) and 37 healthy controls (HCs).
• Statistical analyses identified group differences, and correlation and ROC analyses assessed diagnostic potential.

Main Results:

• Both CSCI and ICSCI groups showed reduced left primary somatosensory cortex (S1) surface area compared to HCs, with CSCI having less than ICSCI.
• Distinct alterations in cortical thickness and volume were observed in regions like the posterior cingulate cortex (PCC), supramarginal gyrus (SMG), and transverse frontopolar cortex.
• Cortical morphometry metrics, including left S1 surface area and right SMG thickness, could differentiate CSCI from ICSCI with high accuracy (AUC=0.7980).

Conclusions:

• Pediatric CSCI and ICSCI exhibit unique patterns of cortical reorganization, particularly in sensory and cognitive-affective integration areas.
• Multidimensional cortical morphometry shows diagnostic potential for distinguishing SCI severity in children.
• These findings support the use of advanced imaging in developing tailored rehabilitation strategies for pediatric SCI.