Combined DDE MRI and Electrophysiology Prediction of Spinal Cord Injury

DDE MRI 和电生理学联合预测脊髓损伤

• 批准号: 10058003
• 负责人: Maxwell Boakye
• 金额: $ 44.38万
• 依托单位: UNIVERSITY OF LOUISVILLE
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2022-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10058003
• 关键词: Acute; Anatomy; Animal Model; Animals; Anisotropy; Axon; Behavioral; Bladder; Classification; Clinical/Radiologic; Conscious; Contusions; Corticospinal Tracts; Craniocerebral Trauma; Data; Diffusion; Diffusion Magnetic Resonance Imaging; Dimensions; Edema; Electrophysiology (science); Family suidae; Functional disorder; Goals; Hemorrhage; Histology; Human; Image; Imaging Techniques; Individual; Inflammation; Injury; International; Length; Lesion; Magnetic Resonance Imaging; Measurement; Measures; Methods; Modeling; Nervous System Physiology; Nervous System Trauma; Neural Conduction; Neurologic; Neurological outcome; Neurophysiology - biologic function; Outcome; Patient-Focused Outcomes; Patients; Physicians; Physiological; Rattus; Recovery; Research; Residual state; Rodent Model; Role; Sedation procedure; Severities; Site; Sphincter; Spinal; Spinal Cord; Spinal Cord Contusions; Spinal cord injury; Spinal cord injury patients; Stimulus; Structure; Thoracic Injuries; Tissues; Translating; Urodynamics; anatomic imaging; axon injury; clinical translation; experimental study; functional outcomes; gray matter; imaging approach; imaging system; improved; indexing; individual patient; injured; novel; outcome forecast; outcome prediction; pressure; prognostic; response; severe injury; translation to humans; urologic; white matter

The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) neurological exam and magnetic resonance imaging (MRI) —the prevailing methods to assess severity of injury and predict prognosis— suffer from significant limitations and often fail to accurately predict long-term outcome in individuals, and neither provides information on the functional and physiological viability of residual cord tissue altered by the injury. Using standard MRI, physicians may grossly under/overestimate the degree of intrinsic cord injury or functional connectivity of cord tissue. Thus, these widely used clinical and radiological assessments are often unable to distinguish between incomplete and complete injuries and more sensitive determinants of long-term outcomes are critically needed. Diffusion tensor imaging (DTI) is an MRI technique that has shown promise in estimating the degree of axonal injury in acutely injured cord in both animal and limited human studies. However, fractional anisotropy (FA), a key DTI parameter that is reduced in acute SCI, is confounded by edema and hemorrhage making its interpretation and reliability problematic. A novel diffusion MRI alternative, double diffusion encoding (DDE), has shown high sensitivity to axonal injury with minimal contribution from edema and accurately predicts outcomes in a rat SCI model. However, rodent models of SCI are limited, and it remains uncertain if DDE performs as reliably in a large animal model more faithfully replicating human SCI. Furthermore, the relationship between DDE and electrophysiological activity, which is critical to establishing the functional integrity or neural conduction block across the injury site, has not been explored. Our goal is to enhance the translational applicability of DDE using a validated large animal porcine contusion model currently being used by our group. Preliminary MRI data from our group using this model matches both the quality and challenges of human SCI imaging. To relate DDE-derived axonal injury index (ADC||) with neural function, we will conduct both DDE assessments and intraoperative D-wave epidural electrophysiology in a porcine contusion SCI model with mild (n=6) and severe (n=6) injury. Successful project completion will lead to direct translation to human SCI patient studies with the long-term goal of improving patient outcomes from such a devastating injury.

脊髓损伤神经学分类国际标准（ISNCSCI）神经学检查 和磁共振成像（MRI）-评估损伤严重程度和预测 预后-具有显著的局限性，通常无法准确预测长期结果， 没有提供关于残余脐带组织的功能和生理活性的信息 因受伤而改变。使用标准MRI，医生可能会严重低估/高估固有的程度。 脊髓损伤或脊髓组织的功能连接。因此，这些广泛使用的临床和放射学 评估通常无法区分不完全和完全损伤， 迫切需要长期成果的决定因素。扩散张量成像（DTI）是一种MRI技术， 这在估计动物和动物急性损伤脊髓的轴突损伤程度方面显示出希望， 有限的人类研究。然而，分数各向异性（FA），一个在急性SCI中降低的关键DTI参数， 被水肿和出血混淆，使其解释和可靠性成问题。一种新型的扩散 MRI的替代，双扩散编码（DDE），已显示出高敏感性轴突损伤与最小 在大鼠脊髓损伤模型中，评估水肿的贡献并准确预测结果。然而，脊髓损伤的啮齿动物模型 是有限的，并且仍然不确定DDE是否在大型动物模型中更忠实地可靠地执行 复制人类脊髓损伤此外，DDE和电生理活动之间的关系， 对于建立损伤部位的功能完整性或神经传导阻滞至关重要， 探讨了我们的目标是使用经验证的大型动物猪来增强DDE的翻译适用性 我们小组正在使用的挫伤模型。我们小组使用该模型的初步MRI数据 符合人体脊髓损伤成像的质量和挑战。将DDE衍生的轴突损伤指数 (ADC||) with neural function, we will conduct both DDE assessments and intraoperative D-wave epidural 在具有轻度（n=6）和重度（n=6）损伤的猪挫伤SCI模型中的电生理学。成功的项目 完成后将直接转化为人类SCI患者研究，其长期目标是改善 患者的预后是如此的严重。

项目成果

Predictive values of spinal cord diffusion magnetic resonance imaging to characterize outcomes after contusion injury.

• DOI: 10.1002/acn3.51855
• 发表时间: 2023-09
• 期刊: ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
• 影响因子: 5.3
• 作者: Ahmed, Rakib Uddin;Medina-Aguinaga, Daniel;Adams, Shawns;Knibbe, Chase A.;Morgan, Monique;Gibson, Destiny;Kim, Joo-won;Sharma, Mayur;Chopra, Manpreet;Davison, Steven;Sherwood, Leslie C.;Negahdar, M. J.;Bert, Robert;Ugiliweneza, Beatrice;Hubscher, Charles;Budde, Matthew D.;Xu, Junqian;Boakye, Maxwell
• 通讯作者: Boakye, Maxwell