Relationship of MRI to ASIA Impairment Scale in Chronic Spinal Cord Injury

MRI 与慢性脊髓损伤 ASIA 损伤量表的关系

• 批准号: 7473387
• 负责人: JOHN W MCDONALD
• 金额: $ 28.18万
• 依托单位: HUGO W. MOSER RES INST KENNEDY KRIEGER
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-01 至 2011-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7473387
• 关键词: Address; American; Animal Model; Anisotropy; Biological Preservation; Brain imaging; Breathing; Caliber; Cardiovascular system; Cerebrospinal Fluid; Characteristics; Chronic; Classification; Clinical; Clinical Trials Design; Development; Diagnosis; Diffusion; Diffusion Magnetic Resonance Imaging; Disease; Distal; Dorsal; Fiber; Goals; Health; Human; Image; Imaging Techniques; Impairment; Individual; Injury; Institutes; Investigation; Joints; Lesion; Life; Light; Magnetic Resonance Imaging; Measurement; Measures; Metatarsal bone structure; Metric; Monitor; Morphologic artifacts; Motion; Motor; Myelin; Nervous System Physiology; Neurologic; Neurologic Examination; Pain; Pathology; Pathway interactions; Persons; Recovery; Research; Research Personnel; Residual state; Resolution; Sensory; Sensory Thresholds; Severities; Signal Transduction; Site; Spinal Cord; Spinal Injuries; Spinal cord injury; Spinal cord injury patients; Structure; System; Testing; Tissues; Touch sensation; Weight; base; bone; computerized; depressed; design; dorsal column; imaging modality; improved; public health relevance; regenerative; respiratory; restorative treatment; spinal cord imaging; spinal cord white matter; tool; treatment planning; vibration; white matter

DESCRIPTION (provided by applicant): The objective of this investigation is two-fold: 1) to add to the classification value of the American Spinal Injury Association (ASIA) Impairment Scale by establishing imaging criteria for chronic spinal cord injury (SCI), 2) to use advanced MR imaging techniques as tools to understand the structural variables that contribute to residual neurological function and the capacity for recovery. A preserved rim of white matter at the injury epicenter characterizes SCI pathology, and the integrity of this tissue determines the amount of preserved function. High resolution imaging is necessary to visualize the subtle structural differences that are responsible for differing levels of function both at the site of and distal to the injury epicenter. Spinal cord imaging is complicated by the small size of the cord, interference from surrounding bone, respiratory and cardiovascular related motion and cerebrospinal fluid pulsation artifacts. Recently, investigators at the F.M. Kirby Research Center for Functional Brain Imaging at Kennedy Krieger Institute have successfully used Diffusion Tensor Imaging (DTI) and Magnetization Transfer (MT) to visualize over sixty injured spinal cords. These imaging techniques are of sufficient resolution and quality to correlate DTI- and MT-derived metrics sensitive to white matter disruption with neurological function in chronic SCI. We address the specific hypothesis that neurological function/deficit clinically defined through the ASIA criteria is related to disordered white matter pathways in persons with chronic SCI through tract specific DTI-derived metrics such as: fractional anisotropy (FA), average diffusion coefficient (MD), parallel and perpendicular eigenvalues (;|| and ;4) and MTCSF (magnetization transfer weighted image normalized by cerebrospinal fluid), but not conventional T1- and T2- weighted imaging. One hundred and twenty individuals divided amongst four ASIA classes (ASIA A-C and E) will be imaged using conventional (T1, T2) and advanced (DTI, MT) MRI techniques. The integrity of white matter both at the site of and distal to the epicenter of the lesion in these subjects will be defined in a tract specific manner using DTI and MT and will be tested for relationships to ASIA clinical classification and neurological motor and sensory testing (Aim1) and to quantitative vibration threshold sensory testing (Aim2). PUBLIC HEALTH RELEVANCE: It is known that the amount of residual spinal cord function after injury is related to the composition and health of the white matter that remains at the level of injury, but currently it is not known exactly how much preservation of the white matter tracts is necessary for neurological function. Development of high resolution, non-invasive imaging methods to determine the integrity of white matter after injury is important for designing and testing restorative treatments for individuals living with SCI. We propose to apply recently improved advanced magnetic resonance imaging (MRI) methods to quantify white matter integrity in the spinal cord and relate the information obtained to the motor and sensory function scores assessed by the American Spine Injury Association (ASIA) Impairment Scale.

描述（由申请人提供）：本研究的目的有两个：1）通过建立慢性脊髓损伤（SCI）的成像标准，增加美国脊髓损伤协会（ASIA）损伤量表的分类值，2）使用先进的MR成像技术作为工具，了解有助于残余神经功能和恢复能力的结构变量。损伤中心保留的白色物质边缘是SCI病理学的特征，该组织的完整性决定了保留功能的数量。高分辨率成像是必要的，以可视化的微妙的结构差异，负责不同水平的功能都在现场和远端的损伤震中。脊髓成像由于脊髓的小尺寸、周围骨骼的干扰、呼吸和心血管相关运动以及脑脊液脉动伪影而变得复杂。最近，F.M.的调查人员Kennedy Krieger研究所的Kirby脑功能成像研究中心已经成功地使用扩散张量成像（DTI）和磁化转移（MT）来可视化60多个受伤的脊髓。这些成像技术具有足够的分辨率和质量，可以将对白色破坏敏感的DTI和MT衍生指标与慢性SCI的神经功能相关联。我们提出了一个特定的假设，即通过ASIA标准临床定义的神经功能/缺陷与慢性SCI患者的白色通路紊乱有关，这一假设是通过特定的DTI指标实现的，这些指标包括：各向异性分数（FA）、平均弥散系数（MD）、平行和垂直特征值（;||（4）与MTCSF（脑脊液标准化磁化传递加权成像），而非常规T1和T2加权成像。将使用常规（T1、T2）和高级（DTI、MT）MRI技术对分为4个ASIA类别（ASIA A-C和E）的120名个体进行成像。将使用DTI和MT以特定于神经束的方式定义这些受试者病变中心部位和远端的白色物质的完整性，并将测试其与ASIA临床分类和神经运动和感觉测试（Aim 1）以及定量振动阈值感觉测试（Aim 2）的关系。公共卫生关系：已知损伤后残留脊髓功能的量与残留在损伤水平的白色物质的组成和健康状况有关，但目前尚不清楚神经功能需要保留多少白色物质束。开发高分辨率、非侵入性的成像方法来确定损伤后白色物质的完整性，对于设计和测试SCI患者的恢复治疗非常重要。我们建议应用最近改进的先进的磁共振成像（MRI）方法来量化脊髓中的白色物质的完整性，并将获得的信息与美国脊柱损伤协会（ASIA）损伤量表评估的运动和感觉功能评分相关联。