Axonal integrity predicts cortical reorganisation following cervical injury.
Axonal integrity predicts cortical reorganisation following cervical injury.
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DOI：
10.1136/jnnp-2011-301875
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发表时间：
2012-06
期刊：
影响因子：
--
通讯作者：
Hutton C
中科院分区：
文献类型：
--
作者：
Freund P;Wheeler-Kingshott CA;Nagy Z;Gorgoraptis N;Weiskopf N;Friston K;Thompson AJ;Hutton C
创伤性脊髓损伤（SCI）导致轴突结构的破坏和宏观组织损失，大脑和脊髓之间的信息流受损-随后的临床损害的假定基础。作者使用临床可行的多模式MRI方案来量化颅侧皮质脊髓束（CST）的轴突完整性，并确定CST的微观结构白色物质变化如何与脊髓横截面积和感觉运动系统的皮质重组相关。创伤性SCI受试者。9名志愿者颈部损伤导致双侧运动障碍和14名对照组进行了研究。作者使用弥散张量成像评估CST中的白色物质完整性，使用T1加权成像测量脊髓横截面积，使用功能性MRI比较运动任务相关的脑激活。采用回归分析评估了微观结构、宏观结构和功能措施之间的关系。扩散张量成像显示SCI受试者的CST与对照组相比在锥体、内囊、大脑脚和手部区域有显著差异。在左侧锥体中观察到的微结构白色物质变化预测左侧M1腿部区域的任务相关反应增加，而大脑脚的变化则通过减少脊髓面积预测。观察到的显微结构变化表明创伤相关的轴突变性和脱髓鞘，这与皮质运动重组和宏观结构。这些变化的程度可能反映了与皮质重组相关的运动通路的可塑性。因此，这种临床上可行的多模态成像方法适用于监测中枢通路的退化和评估SCI中针对轴突修复的治疗。
Traumatic spinal cord injury (SCI) leads to disruption of axonal architecture and macroscopic tissue loss with impaired information flow between the brain and spinal cord—the presumed basis of ensuing clinical impairment. The authors used a clinically viable, multimodal MRI protocol to quantify the axonal integrity of the cranial corticospinal tract (CST) and to establish how microstructural white matter changes in the CST are related to cross-sectional spinal cord area and cortical reorganisation of the sensorimotor system in subjects with traumatic SCI. Nine volunteers with cervical injuries resulting in bilateral motor impairment and 14 control subjects were studied. The authors used diffusion tensor imaging to assess white matter integrity in the CST, T1-weighted imaging to measure cross-sectional spinal cord area and functional MRI to compare motor task-related brain activations. The relationships among microstructural, macrostructural and functional measures were assessed using regression analyses. Diffusion tensor imaging revealed significant differences in the CST of SCI subjects—compared with controls—in the pyramids, the internal capsule, the cerebral peduncle and the hand area. The microstructural white matter changes observed in the left pyramid predicted increased task-related responses in the left M1 leg area, while changes in the cerebral peduncle were predicted by reduced cord area. The observed microstructural changes suggest trauma-related axonal degeneration and demyelination, which are related to cortical motor reorganisation and macrostructure. The extent of these changes may reflect the plasticity of motor pathways associated with cortical reorganisation. This clinically viable multimodal imaging approach is therefore appropriate for monitoring degeneration of central pathways and the evaluation of treatments targeting axonal repair in SCI.
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