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Xie Y, Zhang L, Guo S, Peng R, Gong H, Yang M. Changes in respiratory structure and function after traumatic cervical spinal cord injury: observations from spinal cord and brain. Front Neurol 2023; 14:1251833. [PMID: 37869136 PMCID: PMC10587692 DOI: 10.3389/fneur.2023.1251833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Accepted: 09/18/2023] [Indexed: 10/24/2023] Open
Abstract
Respiratory difficulties and mortality following severe cervical spinal cord injury (CSCI) result primarily from malfunctions of respiratory pathways and the paralyzed diaphragm. Nonetheless, individuals with CSCI can experience partial recovery of respiratory function through respiratory neuroplasticity. For decades, researchers have revealed the potential mechanism of respiratory nerve plasticity after CSCI, and have made progress in tissue healing and functional recovery. While most existing studies on respiratory plasticity after spinal cord injuries have focused on the cervical spinal cord, there is a paucity of research on respiratory-related brain structures following such injuries. Given the interconnectedness of the spinal cord and the brain, traumatic changes to the former can also impact the latter. Consequently, are there other potential therapeutic targets to consider? This review introduces the anatomy and physiology of typical respiratory centers, explores alterations in respiratory function following spinal cord injuries, and delves into the structural foundations of modified respiratory function in patients with CSCI. Additionally, we propose that magnetic resonance neuroimaging holds promise in the study of respiratory function post-CSCI. By studying respiratory plasticity in the brain and spinal cord after CSCI, we hope to guide future clinical work.
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Affiliation(s)
- Yongqi Xie
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Liang Zhang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Shuang Guo
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Rehabilitation, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Run Peng
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
| | - Huiming Gong
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
| | - Mingliang Yang
- School of Rehabilitation Medicine, Capital Medical University, Beijing, China
- Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center, Beijing, China
- Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China
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Zhou R, Li J, Wang R, Chen Z, Zhou F. The neurovascular unit in healthy and injured spinal cord. J Cereb Blood Flow Metab 2023; 43:1437-1455. [PMID: 37190756 PMCID: PMC10414016 DOI: 10.1177/0271678x231172008] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 02/09/2023] [Accepted: 03/24/2023] [Indexed: 05/17/2023]
Abstract
The neurovascular unit (NVU) reflects the close temporal and spatial link between neurons and blood vessels. However, the understanding of the NVU in the spinal cord is far from clear and largely based on generalized knowledge obtained from the brain. Herein, we review the present knowledge of the NVU and highlight candidate approaches to investigate the NVU, particularly focusing on the spinal cord. Several unique features maintain the highly regulated microenvironment in the NVU. Autoregulation and neurovascular coupling ensure regional blood flow meets the metabolic demand according to the blood supply or local neural activation. The blood-central nervous system barrier partitions the circulating blood from neural parenchyma and facilitates the selective exchange of substances. Furthermore, we discuss spinal cord injury (SCI) as a common injury from the perspective of NVU dysfunction. Hopefully, this review will help expand the understanding of the NVU in the spinal cord and inspire new insights into SCI.
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Affiliation(s)
- Rubing Zhou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Junzhao Li
- Neuroscience Research Institute and Department of Neurobiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China
| | - Ruideng Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Zhengyang Chen
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Fang Zhou
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
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The Correlation between Functional Connectivity of the Primary Somatosensory Cortex and Cervical Spinal Cord Microstructural Injury in Patients with Cervical Spondylotic Myelopathy. DISEASE MARKERS 2022; 2022:2623179. [PMID: 35096201 PMCID: PMC8791726 DOI: 10.1155/2022/2623179] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 12/17/2021] [Indexed: 11/23/2022]
Abstract
Objectives To explore functional connectivity reorganization of the primary somatosensory cortex, the chronic microstructure damage of the cervical spinal cord, and their relationship in cervical spondylotic myelopathy (CSM) patients. Methods Thirty-three patients with CSM and 23 healthy controls (HCs) were recruited for rs-fMRI and cervical spinal cord diffusion tensor imaging (DTI) scans. Six subregions (including leg, back, chest, hand, finger and face) of bilateral primary somatosensory cortex (S1) were selected for seed-based whole-brain functional connectivity (FC). Then, we calculated the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values of the cervical spinal cord. Correlation analysis was conducted between FC values of brain regions and DTI parameters of cervical spinal cord (ADC, FA), and their relationship with each other and clinical parameters. Results Compared with the HC group, the CSM group showed decreased FC between areas of the left S1hand, the left S1leg, the right S1chest, and the right S1leg with brain regions. The mean FA values of the cervical spinal cord in CSM patients were positively correlated with JOA scores. Especially, the FApos values of bilateral posterior funiculus were positively correlated with JOA scores. The ADC and FA values of bilateral posterior funiculus in the cervical spinal cord were also positively correlated with the FC values. Conclusions There was synchronization between chronic cervical spinal cord microstructural injury and cerebral cortex sensory function compensatory recombination. DTI parameters of the posterior cervical spinal cord could objectively reflect the degree of cerebral cortex sensory function impairment to a certain extent.
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MRI-based machine learning for determining quantitative and qualitative characteristics affecting the survival of glioblastoma multiforme. Magn Reson Imaging 2021; 85:222-227. [PMID: 34687850 DOI: 10.1016/j.mri.2021.10.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/16/2021] [Accepted: 10/17/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE Our current study aims to consider the image biomarkers extracted from the MRI images for exploring their effects on glioblastoma multiforme (GBM) patients' survival. Determining its biomarker helps better manage the disease and evaluate treatments. It has been proven that imaging features could be used as a biomarker. The purpose of this study is to investigate the features in MRI and clinical features as the biomarker association of survival of GBM. METHODS 55 patients were considered with five clinical features, 10 qualities pre-operative MRI image features, and six quantitative features obtained using BraTumIA software. It was run ANN, C5, Bayesian, and Cox models in two phases for determining important variables. In the first phase, we selected the quality features that occur at least in three models and quantitative in two models. In the second phase, models were run with the extracted features, and then the probability value of variables in each model was calculated. RESULTS The mean of accuracy, sensitivity, specificity, and area under curve (AUC) after running four machine learning techniques were 80.47, 82.54, 79.78, and 0.85, respectively. In the second step, the mean of accuracy, sensitivity, specificity, and AUC were 79.55, 78.71, 79.83, and 0.87, respectively. CONCLUSION We found the largest size of the width, the largest size of length, radiotherapy, volume of enhancement, volume of nCET, satellites, enhancing margin, and age feature are important features.
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Dehghani H, Oghabian MA, Batouli SAH, Arab Kheradmand J, Khatibi A. Effect of Physiological Noise on Thoracolumbar Spinal Cord Functional Magnetic Resonance Imaging in 3T Magnetic Field. Basic Clin Neurosci 2020; 11:737-751. [PMID: 33850611 PMCID: PMC8019845 DOI: 10.32598/bcn.11.6.1395.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/10/2018] [Accepted: 02/19/2019] [Indexed: 11/20/2022] Open
Abstract
Introduction: Functional Magnetic Resonance Imaging (fMRI) methods have been used to study sensorimotor processing in the spinal cord. However, these techniques confront unwanted noises to the measured signal from the physiological fluctuations. In the spinal cord imaging, most of the challenges are consequences of cardiac and respiratory movement artifacts that are considered as significant sources of noise, especially in the thoracolumbar region. In this study, we investigated the effect of each source of physiological noise and their contribution to the outcome of the analysis of the blood-oxygen-level-dependent signal in the human thoracolumbar spinal cord. Methods: Fifteen young healthy male volunteers participated in the study, and pain stimuli were delivered on the L5 dermatome between the two malleoli. Respiratory and cardiac signals were recorded during the imaging session, and the generated respiration and cardiac regressors were included in the general linear model for quantification of the effect of each of them on the task-analysis results. The sum of active voxels of the clusters was calculated in the spinal cord in three correction states (respiration correction only, cardiac correction only, and respiration and cardiac noise corrections) and analyzed with analysis of variance statistical test and receiver operating characteristic curve. Results: The results illustrated that cardiac noise correction had an effective role in increasing the active voxels (Mean±SD = 23.46±9.46) compared to other noise correction methods. Cardiac effects were higher than other physiological noise sources Conclusion: In summary, our results indicate great respiration effects on the lumbar and thoracolumbar spinal cord fMRI, and its contribution to the heartbeat effect can be a significant variable in the individual fMRI data analysis. Displacement of the spinal cord and the effects of this noise in the thoracolumbar and lumbar spinal cord fMRI results are significant and cannot be ignored.
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Affiliation(s)
- Hamed Dehghani
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Science, Tehran, Iran.,Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Science, Tehran, Iran.,Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Amir Hosein Batouli
- Research Center for Molecular and Cellular Imaging (RCMCI), Tehran University of Medical Sciences, Tehran, Iran.,Department of Neuroscience, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalil Arab Kheradmand
- Shefa Neuroscience Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Khatibi
- Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom.,Centre for Human Brain Health, University of Birmingham, Birmingham, United Kingdom
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Lateralized Brainstem and Cervical Spinal Cord Responses to Aversive Sounds: A Spinal fMRI Study. Brain Sci 2018; 8:brainsci8090165. [PMID: 30200289 PMCID: PMC6162493 DOI: 10.3390/brainsci8090165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/25/2018] [Accepted: 08/29/2018] [Indexed: 12/22/2022] Open
Abstract
Previous research has delineated the networks of brain structures involved in the perception of emotional auditory stimuli. These include the amygdala, insula, and auditory cortices, as well as frontal-lobe, basal ganglia, and cerebellar structures involved in the planning and execution of motoric behaviors. The aim of the current research was to examine whether emotional sounds also influence activity in the brainstem and cervical spinal cord. Seventeen undergraduate participants completed a spinal functional magnetic resonance imaging (fMRI) study consisting of two fMRI runs. One run consisted of three one-minute blocks of aversive sounds taken from the International Affective Digitized Sounds (IADS) stimulus set; these blocks were interleaved by 40-s rest periods. The other block consisted of emotionally neutral stimuli also drawn from the IADS. The results indicated a stark pattern of lateralization. Aversive sounds elicited greater activity than neutral sounds in the right midbrain and brainstem, and in right dorsal and ventral regions of the cervical spinal cord. Neutral stimuli, on the other hand, elicited less neural activity than aversive sounds overall; these responses were left lateralized and were found in the medial midbrain and the dorsal sensory regions of the cervical spinal cord. Together, these results demonstrate that aversive auditory stimuli elicit increased sensorimotor responses in brainstem and cervical spinal cord structures.
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Zhang B, Seifert AC, Kim JW, Borrello J, Xu J. 7 Tesla 22-channel wrap-around coil array for cervical spinal cord and brainstem imaging. Magn Reson Med 2016; 78:1623-1634. [DOI: 10.1002/mrm.26538] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 10/12/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Bei Zhang
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai; New York New York USA
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York USA
| | - Alan C. Seifert
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai; New York New York USA
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai; New York New York USA
| | - Joo-won Kim
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai; New York New York USA
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai; New York New York USA
| | - Joseph Borrello
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai; New York New York USA
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai; New York New York USA
| | - Junqian Xu
- Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai; New York New York USA
- Department of Radiology; Icahn School of Medicine at Mount Sinai; New York New York USA
- Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai; New York New York USA
- Department of Neuroscience; Icahn School of Medicine at Mount Sinai; New York New York USA
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Organization of the intrinsic functional network in the cervical spinal cord: A resting state functional MRI study. Neuroscience 2016; 336:30-38. [PMID: 27590264 DOI: 10.1016/j.neuroscience.2016.08.042] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 12/29/2022]
Abstract
Resting state functional magnetic resonance imaging (rsfMRI) has been extensively applied to investigate the organization of functional networks in the brain. As an essential part of the central nervous system (CNS), the spinal cord has not been well explored about its intrinsic functional network. In this study, we aim to thoroughly investigate the characteristics of the intrinsic functional network in the spinal cord using rsfMRI. Functional connectivity and graph theory analysis were employed to evaluate the organization of the functional network, including its topology and network communication properties. Furthermore, the reproducibility of rsfMRI analysis on the spinal cord was also examined by intra-class correlation (ICC). Comprehensive evaluation of the intrinsic functional organization presented a non-uniform distribution of topological characteristics of the functional network, in which the upper levels (C2 and C3 vertebral levels) of the cervical spinal cord showed high levels of connectivity. The present results revealed the significance of the upper cervical cord in the intrinsic functional network of the human cervical spinal cord. In addition, this study demonstrated the efficiency of the cervical spinal cord functional network and the reproducibility of rsfMRI analysis on the spinal cord was also confirmed. As knowledge expansion of intrinsic functional network from the brain to the spinal cord, this study shed light on the organization of the spinal cord functional network in both normal development and clinical disorders.
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Hansen BB, Hansen P, Carrino JA, Fournier G, Rasti Z, Boesen M. Imaging in mechanical back pain: Anything new? Best Pract Res Clin Rheumatol 2016; 30:766-785. [DOI: 10.1016/j.berh.2016.08.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 06/21/2016] [Accepted: 08/04/2016] [Indexed: 12/13/2022]
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Giardini ME, Zippo AG, Valente M, Krstajic N, Biella GEM. Electrophysiological and Anatomical Correlates of Spinal Cord Optical Coherence Tomography. PLoS One 2016; 11:e0152539. [PMID: 27050096 PMCID: PMC4822845 DOI: 10.1371/journal.pone.0152539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 03/15/2016] [Indexed: 11/19/2022] Open
Abstract
Despite the continuous improvement in medical imaging technology, visualizing the spinal cord poses severe problems due to structural or incidental causes, such as small access space and motion artifacts. In addition, positional guidance on the spinal cord is not commonly available during surgery, with the exception of neuronavigation techniques based on static pre-surgical data and of radiation-based methods, such as fluoroscopy. A fast, bedside, intraoperative real-time imaging, particularly necessary during the positioning of endoscopic probes or tools, is an unsolved issue. The objective of our work, performed on experimental rats, is to demonstrate potential intraoperative spinal cord imaging and probe guidance by optical coherence tomography (OCT). Concurrently, we aimed to demonstrate that the electromagnetic OCT irradiation exerted no particular effect at the neuronal and synaptic levels. OCT is a user-friendly, low-cost and endoscopy-compatible photonics-based imaging technique. In particular, by using a Fourier-domain OCT imager, operating at 850 nm wavelength and scanning transversally with respect to the spinal cord, we have been able to: 1) accurately image tissue structures in an animal model (muscle, spine bone, cerebro-spinal fluid, dura mater and spinal cord), and 2) identify the position of a recording microelectrode approaching and inserting into the cord tissue 3) check that the infrared radiation has no actual effect on the electrophysiological activity of spinal neurons. The technique, potentially extendable to full three-dimensional image reconstruction, shows prospective further application not only in endoscopic intraoperative analyses and for probe insertion guidance, but also in emergency and adverse situations (e.g. after trauma) for damage recognition, diagnosis and fast image-guided intervention.
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Affiliation(s)
- Mario E. Giardini
- Department of Biomedical Engineering, University of Strathclyde, Wolfson Centre, 106 Rottenrow, Glasgow G4 0NW, United Kingdom
| | - Antonio G. Zippo
- Institute of Molecular Bioimaging and Physiology, National Research Council (CNR), Via Fratelli Cervi 93, 20090 Segrate (Milan), Italy
| | - Maurizio Valente
- Institute of Molecular Bioimaging and Physiology, National Research Council (CNR), Via Fratelli Cervi 93, 20090 Segrate (Milan), Italy
| | - Nikola Krstajic
- CMOS Sensors Group, Integrated Micro & Nano Systems, School of Engineering, University of Edinburgh, The King's Buildings, Edinburgh EH9 3JL, United Kingdom
| | - Gabriele E. M. Biella
- Institute of Molecular Bioimaging and Physiology, National Research Council (CNR), Via Fratelli Cervi 93, 20090 Segrate (Milan), Italy
- * E-mail:
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Alexander MS, Kozyrev N, Bosma RL, Figley CR, Richards JS, Stroman PW. fMRI Localization of Spinal Cord Processing Underlying Female Sexual Arousal. JOURNAL OF SEX & MARITAL THERAPY 2016; 42:36-47. [PMID: 25635474 DOI: 10.1080/0092623x.2015.1010674] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Using functional magnetic resonance imaging, the authors aimed to determine the roles of the human spinal cord in mediating sexual responses in women. Functional magnetic resonance imaging of the entire lower thoracic, lumbar, and sacral spinal cord was performed using a sexual stimulation paradigm designed to elicit psychological and physical components of sexual arousal. Responses were measured in 9 healthy adult women during 3 consecutive conditions: (a) erotic audiovisual, (b) manual clitoral, and (c) audiovisual plus manual stimulation. Functional magnetic resonance imaging results in healthy subjects demonstrate that this method is sensitive for mapping sexual function in the spinal cord, and identify several key regions involved in human sexual response, including the intermediolateral cell column, the dorsal commissural nucleus, and the sacral parasympathetic nucleus. Using spinal functional magnetic resonance imaging, this study identified many of the spinal cord regions involved in female sexual responses. Results from audiovisual and manual clitoral stimulation correspond with previous data regarding lumbar and sacral neurologic changes during sexual arousal. This study provides the first characterization of neural activity in the human spinal cord underlying healthy female sexual responses and sets a foundation for future studies aimed at mapping changes that result from sexual dysfunction, spinal cord trauma or disease.
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Affiliation(s)
- Marcalee S Alexander
- a Department of Physical Medicine and Rehabilitation , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Natalie Kozyrev
- b Centre for Neuroscience Studies , Queen's University , Kingston , Ontario , Canada
| | - Rachael L Bosma
- b Centre for Neuroscience Studies , Queen's University , Kingston , Ontario , Canada
| | - Chase R Figley
- b Centre for Neuroscience Studies , Queen's University , Kingston , Ontario , Canada
| | - J Scott Richards
- a Department of Physical Medicine and Rehabilitation , University of Alabama at Birmingham , Birmingham , Alabama , USA
| | - Patrick W Stroman
- b Centre for Neuroscience Studies , Queen's University , Kingston , Ontario , Canada
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Kolesar TA, Fiest KM, Smith SD, Kornelsen J. Assessing Nociception by fMRI of the Human Spinal Cord: A Systematic Review. MAGNETIC RESONANCE INSIGHTS 2015; 8:31-9. [PMID: 26543372 PMCID: PMC4624094 DOI: 10.4137/mri.s23556] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 09/14/2015] [Accepted: 09/16/2015] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess the use of fMRI of the spinal cord in measuring noxious stimulation. METHODS The Scopus, Medline, EMBASE, and Web of Science databases were searched, along with the reference lists of included articles. Two independent reviewers screened abstracts, full-text articles, and extracted data. Original research was included if fMRI of the human spinal cord was used to measure responses to noxious stimulation. RESULTS Of the 192 abstracts screened, 19 met the search criteria and were divided according to their focus: investigating pain responses (n = 6), methodology (n = 6), spinal cord injury (n = 2), or cognition–pain interactions (n = 5). All but one study appear to have observed activity in ipsilateral and dorsal gray matter regions in response to noxious stimuli, although contralateral or ventral activity was also widely observed. CONCLUSIONS Although nociception can be investigated using spinal fMRI, establishing reliability, standardizing methodology, and reporting of results will greatly advance this field.
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Affiliation(s)
| | - Kirsten M Fiest
- Department of Internal Medicine, University of Manitoba, Manitoba, Canada
| | - Stephen D Smith
- Department of Psychology, University of Winnipeg, Manitoba, Canada
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Wong CS, Hui GK, Chung EK, Wong SH. Diagnosis and management of neuropathic pain. Pain Manag 2015; 4:221-31. [PMID: 24953074 DOI: 10.2217/pmt.14.7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A recent revision in the definition of neuropathic pain has highlighted this condition as a distinct disease entity. More accurate search for a lesion in the somatosensory nervous system as the pain-generating mechanism will help target the treatment by pharmacological agents. A multidisciplinary approach is recommended, with pharmacotherapy supplemented by psychological therapy and physical rehabilitation, and appropriate interventional treatment for selected refractory cases.
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Affiliation(s)
- Clara Sm Wong
- Department of Anaesthesiology, Queen Elizabeth Hospital, Hong Kong
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Zhang C, Das SK, Yang DJ, Yang HF. Application of magnetic resonance imaging in cervical spondylotic myelopathy. World J Radiol 2014; 6:826-832. [PMID: 25349665 PMCID: PMC4209427 DOI: 10.4329/wjr.v6.i10.826] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 05/03/2014] [Accepted: 09/24/2014] [Indexed: 02/06/2023] Open
Abstract
Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction and is caused by static or dynamic repeated compression of the spinal cord resulting from degenerative arthritis of the cervical spine and some biological injuries to the cervical spine. The T2 signal change on conventional magnetic resonance imaging (MRI) is most commonly associated with neurological deficits. Diffusion tensor imaging and MR spectroscopy show altered microstructure and biochemistry that reflect patient-specific pathogenesis and can be used to predict neurological outcome and response to intervention. Functional MRI can help to assess the neurological functional recovery after decompression surgery for CSM.
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Spinal fMRI of interoceptive attention/awareness in experts and novices. Neural Plast 2014; 2014:679509. [PMID: 25031872 PMCID: PMC4086226 DOI: 10.1155/2014/679509] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Revised: 05/29/2014] [Accepted: 05/30/2014] [Indexed: 12/05/2022] Open
Abstract
Many disciplines/traditions that promote interoceptive (inner sensation of body parts) attention/awareness (IAA) train practitioners to both attend to and be aware of interoceptive sensory experiences in body parts. The effect of such practices has been investigated in previous imaging studies but limited to cerebral neural activity. Here, for the first time, we studied the impact of these practices on the spinal neural activity of experts and novices. We also attempted to clarify the effect of constant and deep breathing, a paradigm utilized in concentration practices to avoid mind wandering, on IAA-related spinal neural activity. Subjects performed IAA tasks with and without a deep and constant breathing pattern in two sessions. Results showed that neural activity in the spinal segment innervating the attended-to body area increased in experts (P = 0.04) when they performed IAA and that this increase was significantly larger for experts versus novices in each of the sessions (P = 0.024). The significant effects of IAA and expertise on spinal neural activity are consistent with and elaborate on previous reports showing similar effects on cerebral neural activity. As the spinal cord directly innervates body parts, the results might indicate that IAA has an instantaneous (possibly beneficial) effect on the physical body after extended training.
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Bosma R, Stroman P. Assessment of data acquisition parameters, and analysis techniques for noise reduction in spinal cord fMRI data. Magn Reson Imaging 2014; 32:473-81. [DOI: 10.1016/j.mri.2014.01.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 01/07/2014] [Accepted: 01/14/2014] [Indexed: 10/25/2022]
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Cadotte DW, Cohen-Adad J, Fehlings MG. Visualizing Integrative Functioning in the Human Brainstem and Spinal Cord With Spinal Functional Magnetic Resonance Imaging. Neurosurgery 2013; 60 Suppl 1:102-9. [DOI: 10.1227/01.neu.0000430767.87725.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Wheeler-Kingshott CA, Stroman PW, Schwab JM, Bacon M, Bosma R, Brooks J, Cadotte DW, Carlstedt T, Ciccarelli O, Cohen-Adad J, Curt A, Evangelou N, Fehlings MG, Filippi M, Kelley BJ, Kollias S, Mackay A, Porro CA, Smith S, Strittmatter SM, Summers P, Thompson AJ, Tracey I. The current state-of-the-art of spinal cord imaging: applications. Neuroimage 2013; 84:1082-93. [PMID: 23859923 DOI: 10.1016/j.neuroimage.2013.07.014] [Citation(s) in RCA: 155] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2013] [Revised: 06/30/2013] [Accepted: 07/04/2013] [Indexed: 12/14/2022] Open
Abstract
A first-ever spinal cord imaging meeting was sponsored by the International Spinal Research Trust and the Wings for Life Foundation with the aim of identifying the current state-of-the-art of spinal cord imaging, the current greatest challenges, and greatest needs for future development. This meeting was attended by a small group of invited experts spanning all aspects of spinal cord imaging from basic research to clinical practice. The greatest current challenges for spinal cord imaging were identified as arising from the imaging environment itself; difficult imaging environment created by the bone surrounding the spinal canal, physiological motion of the cord and adjacent tissues, and small crosssectional dimensions of the spinal cord, exacerbated by metallic implants often present in injured patients. Challenges were also identified as a result of a lack of "critical mass" of researchers taking on the development of spinal cord imaging, affecting both the rate of progress in the field, and the demand for equipment and software to manufacturers to produce the necessary tools. Here we define the current state-of-the-art of spinal cord imaging, discuss the underlying theory and challenges, and present the evidence for the current and potential power of these methods. In two review papers (part I and part II), we propose that the challenges can be overcome with advances in methods, improving availability and effectiveness of methods, and linking existing researchers to create the necessary scientific and clinical network to advance the rate of progress and impact of the research.
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Affiliation(s)
- C A Wheeler-Kingshott
- NMR Research Unit, Queen Square MS Centre, UCL Institute of Neurology, London, England, UK.
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Kornelsen J, Smith SD, McIver TA, Sboto-Frankenstein U, Latta P, Tomanek B. Functional MRI of the thoracic spinal cord during vibration sensation. J Magn Reson Imaging 2012; 37:981-5. [PMID: 23011888 DOI: 10.1002/jmri.23819] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 08/14/2012] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To demonstrate that it is possible to acquire accurate functional magnetic resonance images from thoracic spinal cord neurons. MATERIALS AND METHODS The lower thoracic spinal dermatomes (T7-T11) on the right side of the body were mechanically stimulated by vibration for 15 participants. Neuronal responses to vibration sensation were measured in the thoracic spinal cord using a HASTE sequence on a 3 Tesla MRI system. RESULTS Signal increases were observed in the corresponding lower thoracic spinal cord segments ipsilateral to the side of stimulation in the dorsal aspect of the spinal cord. CONCLUSION This is the first study to provide proof of principle that functional imaging of the entire thoracic spinal cord is possible, by detecting neuronal activity in the thoracic spinal cord during sensory stimulation using spinal fMRI.
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Affiliation(s)
- Jennifer Kornelsen
- National Research Council Institute for Biodiagnostics, Winnipeg, Manitoba, Canada.
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20
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Cadotte DW, Bosma R, Mikulis D, Nugaeva N, Smith K, Pokrupa R, Islam O, Stroman PW, Fehlings MG. Plasticity of the injured human spinal cord: insights revealed by spinal cord functional MRI. PLoS One 2012; 7:e45560. [PMID: 23029097 PMCID: PMC3446947 DOI: 10.1371/journal.pone.0045560] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Accepted: 08/20/2012] [Indexed: 12/14/2022] Open
Abstract
Introduction While numerous studies have documented evidence for plasticity of the human brain there is little evidence that the human spinal cord can change after injury. Here, we employ a novel spinal fMRI design where we stimulate normal and abnormal sensory dermatomes in persons with traumatic spinal cord injury and perform a connectivity analysis to understand how spinal networks process information. Methods Spinal fMRI data was collected at 3 Tesla at two institutions from 38 individuals using the standard SEEP functional MR imaging techniques. Thermal stimulation was applied to four dermatomes in an interleaved timing pattern during each fMRI acquisition. SCI patients were stimulated in dermatomes both above (normal sensation) and below the level of their injury. Sub-group analysis was performed on healthy controls (n = 20), complete SCI (n = 3), incomplete SCI (n = 9) and SCI patients who recovered full function (n = 6). Results Patients with chronic incomplete SCI, when stimulated in a dermatome of normal sensation, showed an increased number of active voxels relative to controls (p = 0.025). There was an inverse relationship between the degree of sensory impairment and the number of active voxels in the region of the spinal cord corresponding to that dermatome of abnormal sensation (R2 = 0.93, p<0.001). Lastly, a connectivity analysis demonstrated a significantly increased number of intraspinal connections in incomplete SCI patients relative to controls suggesting altered processing of afferent sensory signals. Conclusions In this work we demonstrate the use of spinal fMRI to investigate changes in spinal processing of somatosensory information in the human spinal cord. We provide evidence for plasticity of the human spinal cord after traumatic injury based on an increase in the average number of active voxels in dermatomes of normal sensation in chronic SCI patients and an increased number of intraspinal connections in incomplete SCI patients relative to healthy controls.
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Affiliation(s)
- David W. Cadotte
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Rachael Bosma
- Centre for Neuroscience Studies, Queen’s University, Kingston, Ontario, Canada
| | - David Mikulis
- Department of Radiology, Division of Neuroradiology, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Natalia Nugaeva
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Karen Smith
- Providence Health Care, Spinal Rehabilitation Unit, Kingston, Ontario, Canada
| | - Ronald Pokrupa
- Division of Neurosurgery, Kingston General Hospital, Queen’s University, Kingston, Ontario, Canada
| | - Omar Islam
- Department of Radiology, Division of Neuroradiology and Head & Neck Imaging, Kingston General and Hotel Dieu Hospitals, Queen’s University, Kingston, Ontario, Canada
| | - Patrick W. Stroman
- Centre for Neuroscience Studies, Queen’s University, Kingston, Ontario, Canada
- Departments of Diagnostic Radiology and Physics, Queen’s University, Kingston, Ontario, Canada
| | - Michael G. Fehlings
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Surgery, Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- Division of Genetics and Development, Toronto Western Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- * E-mail:
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21
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Cadotte DW, Mariampillai A, Cadotte A, Lee KKC, Kiehl TR, Wilson BC, Fehlings MG, Yang VXD. Speckle variance optical coherence tomography of the rodent spinal cord: in vivo feasibility. BIOMEDICAL OPTICS EXPRESS 2012; 3:911-919. [PMID: 22567584 PMCID: PMC3342196 DOI: 10.1364/boe.3.000911] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 03/24/2012] [Accepted: 03/31/2012] [Indexed: 05/29/2023]
Abstract
Optical coherence tomography (OCT) has the combined advantage of high temporal (µsec) and spatial (<10µm) resolution. These features make it an attractive tool to study the dynamic relationship between neural activity and the surrounding blood vessels in the spinal cord, a topic that is poorly understood. Here we present work that aims to optimize an in vivo OCT imaging model of the rodent spinal cord. In this study we image the microvascular networks of both rats and mice using speckle variance OCT. This is the first report of depth resolved imaging of the in vivo spinal cord using an entirely endogenous contrast mechanism.
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Affiliation(s)
- David W. Cadotte
- Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
- These authors contributed equally to this work
| | - Adrian Mariampillai
- Biophotonics and Bioengineering Laboratory, Ryerson University, Toronto, Ontario, Canada
- Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada
- These authors contributed equally to this work
| | - Adam Cadotte
- Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Kenneth K. C. Lee
- Biophotonics and Bioengineering Laboratory, Ryerson University, Toronto, Ontario, Canada
- Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Tim-Rasmus Kiehl
- Department of Pathology, University of Toronto, Toronto, Ontario, Canada
| | - Brian C. Wilson
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Michael G. Fehlings
- Division of Neurosurgery, Toronto Western Hospital, Toronto, Ontario, Canada
- Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Krembil Neuroscience Centre, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Victor X. D. Yang
- Biophotonics and Bioengineering Laboratory, Ryerson University, Toronto, Ontario, Canada
- Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada
- Department of Electrical and Computer Engineering, Ryerson University, Toronto, Ontario, Canada
- Department of Medical Imaging, St. Michael’s Hospital, Toronto, Ontario, Canada
- Division of Neurosurgery, St. Michael’s Hospital, Toronto, Ontario, Canada
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22
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Assessment of physiological noise modelling methods for functional imaging of the spinal cord. Neuroimage 2012; 60:1538-49. [DOI: 10.1016/j.neuroimage.2011.11.077] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 10/26/2011] [Accepted: 11/25/2011] [Indexed: 11/22/2022] Open
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Figley CR, Stroman PW. Measurement and characterization of the human spinal cord SEEP response using event-related spinal fMRI. Magn Reson Imaging 2012; 30:471-84. [PMID: 22285878 DOI: 10.1016/j.mri.2011.12.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 10/14/2011] [Accepted: 12/04/2011] [Indexed: 01/21/2023]
Abstract
Although event-related fMRI is able to reliably detect brief changes in brain activity and is now widely used throughout systems and cognitive neuroscience, there have been no previous reports of event-related spinal cord fMRI. This is likely attributable to the various technical challenges associated with spinal fMRI (e.g., imaging a suitable length of the cord, reducing image artifacts from the vertebrae and intervertebral discs, and dealing with physiological noise from spinal cord motion). However, with many of these issues now resolved, the largest remaining impediment for event-related spinal fMRI is a deprived understanding of the spinal cord fMRI signal time course. Therefore, in this study, we used a proton density-weighted HASTE sequence, with functional contrast based on signal enhancement by extravascular water protons (SEEP), and a motion-compensating GLM analysis to (i) characterize the SEEP response function in the human cervical spinal cord and (ii) demonstrate the feasibility of event-related spinal fMRI. This was achieved by applying very brief (1 s) epochs of 22°C thermal stimulation to the palm of the hand and measuring the impulse response function. Our results suggest that the spinal cord SEEP response (time to peak ≈8 s; FWHM ≈4 s; and probably lacking pre- and poststimulus undershoots) is slower than previous estimates of SEEP or BOLD responses in the brain, but faster than previously reported spinal cord BOLD responses. Finally, by detecting and mapping consistent signal-intensity changes within and across subjects, and validating these regions with a block-designed experiment, this study represents the first successful demonstration of event-related spinal fMRI.
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Affiliation(s)
- Chase R Figley
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
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Kozyrev N, Figley CR, Alexander MS, Richards JS, Bosma RL, Stroman PW. Neural correlates of sexual arousal in the spinal cords of able-bodied men: a spinal fMRI investigation. JOURNAL OF SEX & MARITAL THERAPY 2012; 38:418-435. [PMID: 22900624 DOI: 10.1080/0092623x.2011.606887] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The purpose of this study was to determine whether spinal cord functional magnetic resonance imaging could be used to map neural activity throughout the lower thoracic, lumbar, and sacral spinal cord regions during sexual arousal in healthy men. The authors found that viewing erotic films and genital self-stimulation elicited predominantly increased signal, indicative of amplified neuronal input to the dorsal and ventral horns and in the autonomic preganglionic nuclei of the lower thoracic, lumbar, and sacral spinal cord. In addition, linear regression analyses revealed a number of robust correlations (|R| ≥ 0.7) between signal intensity changes in these spinal cord regions and self-reported ratings of mental and physical sexual arousal. Taken together, these results demonstrate that spinal cord functional magnetic resonance imaging is an effective and sensitive technique for mapping the neural correlates of sexual arousal in the spinal cords of able-bodied men. Most important, the results from this study indicate that spinal cord functional magnetic resonance imaging may have important applications as a clinical tool for assessing and mapping the changes that occur in the spinal cords of men suffering from sexual dysfunction as a result of spinal cord trauma.
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Affiliation(s)
- Natalie Kozyrev
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, Canada
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Stroman PW, Bosma RL, Tsyben A. Somatotopic arrangement of thermal sensory regions in the healthy human spinal cord determined by means of spinal cord functional MRI. Magn Reson Med 2011; 68:923-31. [DOI: 10.1002/mrm.23292] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2011] [Revised: 09/30/2011] [Accepted: 10/17/2011] [Indexed: 11/08/2022]
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26
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Haughton V. New imaging strategies in degenerative disease of the intervertebral disks: functional spine imaging. Neuroradiol J 2011; 24:560-3. [PMID: 24059713 DOI: 10.1177/197140091102400411] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 01/03/2011] [Indexed: 11/17/2022] Open
Abstract
As it does for the brain, functional imaging provides additional clinically valuable information on the spine, especially in the problem of back and neck pain. While conventional anatomic spine imaging demonstrates many abnormalities, such as herniation of the intervertebral disk, with nearly perfect accuracy, it does not effectively distinguish incidental degenerative changes in the disk from those that results in pain production. Functional imaging of the spine, still under development and evaluation, will facilitate the identification of painful disks and the selection of patients for innovative treatments that are presently under development. Functional imaging of the spine includes: MR spectroscopy, fMRI of the spinal cord, diffusion imaging, T2 relaxation time, T1 rho measurement and dynamic imaging. The purpose of this presentation is to review the status of these functional MR techniques. MRS: MR spectroscopy demonstrates tissue constituents that have characteristic resonant frequencies. For the disk, the substances that can be recognized in MR spectra and quantified include lactic acid and glycosaminoglycans. Lactic acid has been documented by direct sampling of the disk in painful degenerating disks. With MRS, the concentration of lactic acid is measured non-invasively. In pilot studies, lactic acid concentration effectively distinguishes symptomatic from asymptomatic degenerating disks.
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Affiliation(s)
- V Haughton
- Radiology Department, Wisconsin University Hospitals; Madison, Wisconsin, USA -
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27
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Frøkjær JB, Olesen SS, Graversen C, Andresen T, Lelic D, Drewes AM. Neuroimaging of the human visceral pain system–A methodological review. Scand J Pain 2011; 2:95-104. [DOI: 10.1016/j.sjpain.2011.02.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Accepted: 02/25/2011] [Indexed: 12/13/2022]
Abstract
Abstract
During the last decades there has been a tremendous development of non-invasive methods for assessment of brain activity following visceral pain. Improved methods for neurophysiological and brain imaging techniques have vastly increased our understanding of the central processing of gastrointestinal sensation and pain in both healthy volunteers as well as in patients suffering from gastrointestinal disorders. The techniques used are functional magnetic resonance imaging (fMRI), positron emission tomography (PET), electroencephalography (EEG)/evoked brain potentials (EPs), magnetoencephalography (MEG), single photon emission computed tomography (SPECT), and the multimodal combinations of these techniques. The use of these techniques has brought new insight into the complex brain processes underlying pain perception, including a number of subcortical and cortical regions, and paved new ways in our understanding of acute and chronic pain. The pathways are dynamic with a delicate balance between facilitatory and inhibitory pain mechanisms, and with modulation of the response to internal or external stressors with a high degree of plasticity. Hence, the ultimate goal in imaging of pain is to follow the stimulus response throughout the neuraxis.
Brain activity measured by fMRI is based on subtracting regional changes in blood oxygenation during a resting condition from the signal during a stimulus condition, and has high spatial resolution but low temporal resolution. SPECT and PET are nuclear imaging techniques where radiolabeled molecules are injected with visualization of the distribution, density and activity of receptors in the brain allowing not only assessment of brain activity but also study of receptor sites. EEG is based on assessment of electrical activity in the brain, and recordings of the resting EEG and evoked potentials following an external stimulus are used to study normal visceral pain processing, alterations of pain processing in different patient groups and the effect of pharmacological intervention. EEG has high temporal resolution, but relative poor spatial resolution, which however to some extent can be overcome by applying inverse modelling algorithms and signal decomposition procedures. MEG is based on recording the magnetic fields produced by electrical currents in the brain, has high spatial resolution and is especially suitable for the study cortical activation.
The treatment of chronic abdominal pain is often ineffective and dissapointing, which leads to search for optimized treatment achieved on the basis of a better understanding of underlying pain mechanisms. Application of the recent improvements in neuroimaging on the visceral pain system may likely in near future contribute substantially to our understanding of the functional and structural pathophysiology underlying chronic visceral pain disorders, and pave the road for optimized individual and mechanism based treatments.
The purpose of this review is to give a state-of-the-art overview of these methods, with focus on EEG, and especially the advantages and limitations of the single methods in clinical gastrointestinal pain esearch including examples from relevant studies.
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Affiliation(s)
- Jens Brøndum Frøkjær
- Mech-Sense , Department of Gastroenterology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
- Department of Radiology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
| | - Søren Schou Olesen
- Mech-Sense , Department of Gastroenterology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
| | - Carina Graversen
- Mech-Sense , Department of Gastroenterology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
| | - Trine Andresen
- Mech-Sense , Department of Gastroenterology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
| | - Dina Lelic
- Mech-Sense , Department of Gastroenterology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
| | - Asbjørn Mohr Drewes
- Mech-Sense , Department of Gastroenterology , Aalborg Hospital , Aarhus University Hospital , Aalborg , Denmark
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Cahill CM, Stroman PW. Mapping of neural activity produced by thermal pain in the healthy human spinal cord and brain stem: a functional magnetic resonance imaging study. Magn Reson Imaging 2011; 29:342-52. [DOI: 10.1016/j.mri.2010.10.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Revised: 09/07/2010] [Accepted: 10/23/2010] [Indexed: 01/04/2023]
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29
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Critchley HD, Nagai Y, Gray MA, Mathias CJ. Dissecting axes of autonomic control in humans: Insights from neuroimaging. Auton Neurosci 2011; 161:34-42. [DOI: 10.1016/j.autneu.2010.09.005] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Revised: 09/08/2010] [Accepted: 09/09/2010] [Indexed: 12/30/2022]
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30
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Tansey KE. Neural plasticity and locomotor recovery after spinal cord injury. PM R 2011; 2:S220-6. [PMID: 21172684 DOI: 10.1016/j.pmrj.2010.10.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Accepted: 10/08/2010] [Indexed: 11/15/2022]
Abstract
The discussion of neural plasticity and locomotor recovery after spinal cord injury (SCI) focuses on 2 main themes, the issues associated with detecting neural plasticity in human beings and the issue of how to translate information from animal models, in which neural plasticity can be more readily studied, to human clinical research and application. This article discusses the importance of studying neural plasticity to better understand the effects of current rehabilitation interventions and to devise the next generation of therapies. It reviews the current spectrum of clinical, functional, anatomical, and neurophysiological assessments of patients that can be made in neurorehabilitation and the relationship between those measures and the study of neural plasticity. Then the similarities and differences between animal models and human SCI are discussed in relation to the severity of injury, the effect of locomotor training on gait recovery, the localization of neural plasticity associated with that gait recovery, and the implications for interpreting the "translatability" of animal model data to human study and clinical practice. In summary, it is concluded that the study of neural plasticity and locomotor recovery after SCI is really in its infancy but that it is critical for the advancement of the science of neurorehabilitation and "restorative neurology."
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Affiliation(s)
- Keith E Tansey
- SCI Research, Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA.
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Non-invasive measurement of oxygen saturation in the spinal vein using SWI: quantitative evaluation under conditions of physiological and caffeine load. Neuroimage 2010; 54:344-9. [PMID: 20727413 DOI: 10.1016/j.neuroimage.2010.08.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2010] [Revised: 07/27/2010] [Accepted: 08/11/2010] [Indexed: 11/23/2022] Open
Abstract
Susceptibility-weighted imaging (SWI) has been used for quantitative and non-invasive measurement of blood oxygen saturation in the brain. In this study, we used SWI for quantitative measurement of oxygen saturation in the spinal vein to look for physiological- or caffeine-induced changes in venous oxygenation. SWI measurements were obtained for 5 healthy volunteers using 1.5-T MR units, under 1) 3 kinds of physiological load (breath holding, Bh; hyperventilation, Hv; and inspiration of highly concentrated oxygen, Ox) and 2) caffeine load. Oxygen saturation in the anterior spinal vein (ASV) was calculated. We evaluated changes in oxygen saturation induced by physiological load. We also evaluated the time-course of oxygen saturation after caffeine intake. For the physiological load measurements, the average oxygen saturation for the 5 subjects was significantly lower in Hv (0.75) and significantly higher in Bh (0.84) when compared with control (0.80). There was no significant difference between Ox (0.81) and control. Oxygen saturation gradually decreased after caffeine intake. The average values of oxygen saturation were 0.79 (0 min), 0.76 (20 min), 0.74 (40 min), and 0.73 (60 min), respectively. We demonstrated a significant difference in oxygen saturation at 40 and 60 min after caffeine intake when compared with 0 min. In conclusion, we demonstrated the feasibility of using SWI for non-invasive measurement of oxygen saturation in the spinal vein. We showed changes in oxygen saturation under physiological as well as caffeine load and suggest that this method is a useful tool for the clinical evaluation of spinal cord oxygenation.
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