Subject-specific regional measures of water diffusion are associated with impairment in chronic spinal cord injury.

Purpose: We aimed to identify non-invasive imaging parameters that can serve as biomarkers for the integrity of the spinal cord, which is paramount to neurological function. Diffusion tensor imaging (DTI) indices are sensitive to axonal and myelin damage, and have strong potential to serve as such b...

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Published in:Neuroradiology Vol. 59; no. 8; pp. 747 - 759
Main Authors: Choe, Ann, Sadowsky, Cristina, Smith, Seth, van Zijl, Peter, Pekar, James, Belegu, Visar
Format: diagnostic images research tables/charts Journal Article
Published: Springer Nature Aug2017
Online Access:View this record in EBSCOhost
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      dt: Aug2017
      vid: 59
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00234-017-1860-9
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        atl: Subject-specific regional measures of water diffusion are associated with impairment in chronic spinal cord injury.
      aug:
        au:
          Choe, Ann
          Sadowsky, Cristina
          Smith, Seth
          van Zijl, Peter
          Pekar, James
          Belegu, Visar
      sug:
        subj:
          Spinal Cord Injuries
          Spinal Cord
          Veterans Organizations
          Umbilical Cord
          Cervical Cord
          Diffusion
          Weights and Measures
          Linear Regression
          Two-Way Analysis of Variance
          Data Analysis
          Regression
          Descriptive Statistics
          Clinical Trials
          Case Studies
          Record Review
          Prospective Studies
          Effect Size
          Post Hoc Analysis
          Sensitivity and Specificity
          Analysis of Variance
          Scales
          Reliability
          Surveys
      ab: Purpose: We aimed to identify non-invasive imaging parameters that can serve as biomarkers for the integrity of the spinal cord, which is paramount to neurological function. Diffusion tensor imaging (DTI) indices are sensitive to axonal and myelin damage, and have strong potential to serve as such biomarkers. However, averaging DTI indices over large regions of interest (ROIs), a common approach to analyzing the images of injured spinal cord, leads to loss of subject-specific information. We investigated if DTI-tractography-driven, subject-specific demarcation approach can yield measures that are more specific to impairment. Methods: In 18 individuals with chronic spinal cord injury (SCI), subject-specific demarcation of the injury region was performed using DTI tractography, which yielded three regions relative to injury (RRI; regions superior to, at, and below injury epicenter). DTI indices averaged over each RRI were correlated with measures of residual motor and sensory function, obtained using the International Standard of Neurological Classification for Spinal Cord Injury (ISNCSCI). Results: Total ISNCSCI score (ISNCSCI-tot; sum of ISNCSCI motor and sensory scores) was significantly ( p < 0.05) correlated with fractional anisotropy and axial and radial diffusivities. ISNCSCI-tot showed strongest correlation with indices measured from the region inferior to the injury epicenter (IRRI), the degree of which exceeded that of those measured from the entire cervical cord-suggesting contribution from Wallerian degeneration. Conclusion: DTI tractography-driven, subject-specific injury demarcation approach provided measures that were more specific to impairment. Notably, DTI indices obtained from the IRRI region showed the highest specificity to impairment, demonstrating their strong potential as biomarkers for the SCI severity.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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