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Wang J, Huang J, Sun Z, Dong H, Li K, Lu J. Structural changes in spinal cord following optic neuritis: Insights from quantitative spinal MRI. Brain Res 2024; 1831:148830. [PMID: 38408557 DOI: 10.1016/j.brainres.2024.148830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 02/28/2024]
Abstract
OBJECTIVES Previous studies have demonstrated that optic neuritis (ON) affects brain plasticity. However, whether ON affects the spinal cord remains unclear. We aimed to investigate the spinal cord changes in ON and their associations with disability. METHODS A total of 101 ON patients, and 41 healthy controls (HC) were retrospectively recruited. High-resolution imaging was conducted using a Magnetization Prepared Rapid Acquisition Gradient-Echo (MP-RAGE) sequence for T1-weighted images and an echo planar imaging (EPI) sequence for Diffusion Tensor Imaging (DTI) data collection. Additionally, patients' disability and cognitive impairment were evaluated using the Expanded Disability Status Scale (EDSS) and the Paced Auditory Serial Addition Test (PASAT), respectively. The quantitative spinal MRI was employed to examine the cross-sectional area (CSA) and diffusion indicators, with a specific focus on calculating the average values across the C2-C7 cervical spinal cord segments. CSA, fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were compared between groups. Correlation analyses were performed between CSA, diffusion indicators, and clinical variables. RESULTS No significant differences were found in CSA between ON patients and HCs. MD (p = 0.007) and RD (p = 0.018) were increased in ON patients compared with HCs, and AD was decreased in ON (p = 0.013). The AD values of the ON patients were significantly positively correlated with PASAT scores (r = 0.37, p < 0.001). CONCLUSIONS This study provided imaging evidence for DTI abnormalities in patients with ON. Spinal cord DTI can improve our knowledge of the path physiology of ON, and clinical progression.
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Affiliation(s)
- Jiyuan Wang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Jing Huang
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Zheng Sun
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Huiqing Dong
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Kuncheng Li
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Jie Lu
- Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China.
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Zheng Z, Couture D, Adams F, Roberson R, Ma R, Argenta L, Morykwas M. Attenuated Tissue Damage With Mechanical Tissue Resuscitation in a Pig Model of Spinal Cord Injury. J Neurotrauma 2024; 41:1020-1029. [PMID: 37830176 DOI: 10.1089/neu.2023.0172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2023] Open
Abstract
Our previous studies on the treatment of spinal cord injuries with Mechanical Tissue Resuscitation (MTR) in rats have demonstrated that it can significantly improve the locomotor recovery and Basso Beattie Bresnahan scores. MTR treatment also reduced fluid accumulations by T2-imaging and improved the mean neural fiber number and fiber length in injured sites by fiber tractography. Myelin volume was also significantly preserved by MTR treatment. For further clinical application, a large animal model is necessary to assess this treatment. This study examined the effects of application of MTR on traumatic spinal cord injury in a swine model. Traumatic spinal cord contusion injuries in swine were created by controlled pneumatic impact device. Negative pressure at -75 mm Hg was continuously applied to the injured site through open cell silicone manifold for 7 days. In vivo magnetic resonance imaging for T2 and gradient echo (GRE) analysis employed a 3T machine, while a 7T machine was employed for diffusion tensor imaging (DTI) and fiber tractography. Histological hematoxylin and eosin (H&E) and Luxol fast blue staining were examined. MTR significantly reduced the mean injured volumes over 46% by T2-imaging in the injured sites from 477.34 ± 146.31 mm3 in non-treated group to 255.99 ± 70.28 mm3 in MTR treated group (p < 0.01). It also reduced fluid accumulations by relative T2 signal density in the epicenter of the spinal cord injury from 1.62 ± 0.27 in non-treated group to 1.22 ± 0.10 in the MTR treated group (p < 0.05). The mean injured tissue volume measured by H&E staining was 303.71 ± 78.21 mm3 in the non-treated group and decreased significantly to 162.16 ± 33.0 mm3 in the MTR treated group (p < 0.01). The myelin fiber bundles stained by Luxol blue were preserved much more in the MTR treated group (90 ± 29.71 mm3) than in the non-treated group (33.68 ± 24.99 mm3, p < 0.01). The fractional anisotropy (FA) values processed by DTI analysis are increased from 0.203 ± 0.027 in the untreated group to 0.238 ± 0.029 in MTR treatment group (p < 0.05). Fiber tractography showings the mean fiber numbers across the impacted area were increased over 112% from 327.0 ± 99.74 in the non-treated group to 694.83 ± 297.86 in the MTR treated group (p < 0.05). These results indicate local application of MTR for 7 days to spinal cord injury in a swine model decreased tissue injury, reduced tissue edema, and preserved more myelin fibers as well as nerve fibers in the injured spinal cord.
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Affiliation(s)
- Zhenlin Zheng
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
| | - Daniel Couture
- Department of Neurosurgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
| | - Farren Adams
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
| | - Rebecca Roberson
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
| | - Rong Ma
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
| | - Louis Argenta
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
| | - Michael Morykwas
- Department of Plastic and Reconstructive Surgery, Wake Forest University Health Science, Winston-Salem, North Carolina, USA
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Middleton DM, Shahrampour S, Krisa L, Liu W, Nair G, Jacobson S, Conklin CJ, Alizadeh M, Faro SH, Mulcahey MJ, Mohamed FB. Correlations of diffusion tensor imaging and clinical measures with spinal cord cross-sectional area measurements in pediatric spinal cord injury patients. J Spinal Cord Med 2023; 46:950-957. [PMID: 34855576 PMCID: PMC10653768 DOI: 10.1080/10790268.2021.1997027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The purpose of this work was to employ a semi-automatic method for measuring spinal cord cross-sectional area (SCCSA) and investigate the correlations between diffusion tensor imaging (DTI) metrics and SCCSA for the cervical and thoracic spinal cord for typically developing pediatric subjects and pediatric subject with spinal cord injury. METHODS Ten typically developing (TD) pediatric subjects and ten pediatric subjects with spinal cord injury (SCI) were imaged using a Siemens Verio 3 T MR scanner to acquire DTI and high-resolution anatomic scans covering the cervical and thoracic spinal cord (C1-T12). SCCSA was measured using a semi-automated edge detection algorithm for the entire spinal cord. DTI metrics were obtained from whole cord axial ROIs at each vertebral level. SCCSA measures were compared to DTI metrics by vertebral level throughout the entire cord, and above and below the injury site. Correlation analysis was performed to compare SCCSA, DTI and clinical measures as determined by the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination. RESULTS In subjects with SCI, FA and SCCSA had a positive correlation (r = 0.81, P < 0.01), while RD and SCCSA had a negative correlation (r = -0.68, P = 0.02) for the full spinal cord. FA and SCCSA were correlated above (r = 0.56, P < 0.01) and below (r = 0.54, P < 0.01) the injury site. TD subjects showed negative correlations between AD and SCCSA (r = -0.73, P = 0.01) and RD and SCCSA (r = -0.79, P < 0.01). CONCLUSION The ability to quickly and effectively measure SCCSA in subjects with SCI has the potential to allow for a better understanding of the progression of atrophy following a SCI. Correlations between cord cross section and DTI metrics by vertebral level suggest that imaging inferior and superior to lesion may yield useful information for diagnosis and prognosis.
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Affiliation(s)
- Devon M. Middleton
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Shiva Shahrampour
- Department of Bioengineering, Temple University, Philadelphia, Pennsylvania, USA
| | - Laura Krisa
- College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Winston Liu
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Govind Nair
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | - Steven Jacobson
- National Institutes of Health, National Institute of Neurological Disorders and Stroke, Bethesda, Maryland, USA
| | | | - Mahdi Alizadeh
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Scott H. Faro
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - M. J. Mulcahey
- College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Feroze B. Mohamed
- Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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4
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Zheng W, Wang L, Yang B, Chen Q, Hu Y, Du J, Li X, Chen X, Qin W, Li B, Liang T, Li K, Lu J, Chen N. Specific brain gray matter volume changes in pediatric complete spinal cord injury without fracture or dislocation using voxel-based morphometry analysis: Preliminary Results. J Neurotrauma 2022; 40:931-938. [PMID: 35950623 DOI: 10.1089/neu.2022.0247] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study aims to investigate the brain gray matter volume (GMV) alterations of pediatric complete thoracolumbar spinal cord injury without fracture or dislocation (SCIWOFD) using voxel-based morphometry (VBM) analysis and assess the sensitive neuroimaging biomarkers which may be surrogate targets to enhance brain plasticity. A total of 52 pediatric subjects (age range, 6-12 years), including 25 pediatric SCIWOFD patients and 27 typically developing (TD) children were recruited. Independent two-sample t test was performed to assess between-group differences of brain GMV. Partial correlation analyses were performed to explore the correlations between GMV values and ISNCSCI scores, age at the time of injury, time after initial SCI. Receiver operating characteristic (ROC) analysis was performed to compute the sensitivity and specificity of the imaging biomarkers for pediatric SCIWOFD diagnosis. As the results, pediatric SCIWOFD patients showed significantly decreased GMV of bilateral Cerebellum lobule VIII, right middle occipital gyrus (MOG) and putamen (PUT), left pallidum (PAL) and thalamus (THA), and increased GMV of Vermis_III, right Cerebellum lobule VI and SupraMarginal gyrus (SMG). Additionally, GMV of left PAL and right PUT were negatively correlated with the pinprick/light touch sensory scores in pediatric SCIWOFD patients. Finally, when using the GMV values of left PAL and right PUT in combination as the predictor, area under the curve (AUC) reached the highest, of 0.93. These findings provided evidence that the brain undergoes GMV changes following pediatric SCIWOFD, which may suggest important targets for functional remodeling after SCI in children and provide valuable information for the development of novel and effective rehabilitation therapies in the future.
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Affiliation(s)
- Weimin Zheng
- Xuanwu Hospital Capital Medical University, Department of Radiology and Nuclear medicine, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China, Beijing, Beijing, China;
| | - Ling Wang
- Xuanwu Hospital Capital Medical University, Department of Radiology and Nuclear medicine, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China;
| | - Beining Yang
- Xuanwu Hospital Capital Medical University, Department of Radiology and Nuclear medicine, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China;
| | - Qian Chen
- Capital Medical University Affiliated Beijing Friendship Hospital Department of Radiology, Beijing, China;
| | - Yongsheng Hu
- Xuanwu Hospital Capital Medical University, Department of Functional Neurosurgery, Beijing, China;
| | - Jubao Du
- Xuanwu Hospital Capital Medical University, Department of Rehabilitation Medicine, Beijing, China;
| | - Xuejing Li
- China Rehabilitation Research Center, Department of Radiology, Beijing, Beijing, China;
| | - Xin Chen
- Xuanwu Hospital, Capital Medical University, Beijing, PR China, Department of Radiology and Nuclear medicine, Beijing, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China, Beijing, Beijing, China;
| | - Wen Qin
- Department of Radiology, Tianjin Medical University General Hospital, , Tianjin, Tianjin, China;
| | - Baowei Li
- Affiliated Hospital of Hebei Engineering University, Department of medical imaging, Handan, Hebei, China;
| | - Tengfei Liang
- Affiliated Hospital of Hebei Engineering University, Department of medical imaging, Handan, Hebei, China;
| | - Kuncheng Li
- Xuanwu Hospital, Capital Medical University,Beijing, PR China, Department of Radiology and Nuclear medicine, Beijing, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, PR China, Beijing, Beijing, China;
| | - Jie Lu
- Xuanwu Hospital Capital Medical University, Department of Radiology and Nuclear medicine, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China;
| | - Nan Chen
- Xuanwu Hospital Capital Medical University, Department of Radiology and Nuclear medicine, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China;
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5
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Kauthankar AA, Jaseemudheen M. Diffusion Tensor Imaging in Spinal Cord Injury: A Review. JOURNAL OF HEALTH AND ALLIED SCIENCES NU 2022. [DOI: 10.1055/s-0042-1751068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
AbstractMagnetic resonance diffusion tensor imaging (DTI) is a recent technique that can measure the direction and magnitude of diffusion of water. It is widely being utilized to evaluate several brain and spinal cord pathologies. The objective of this review is to evaluate the importance of the DTI in patients with spinal cord injury (SCI). It aims to review various articles on DTI SCI and includes both animal and human studies. This will help to describe the current status of the clinical applications of DTI and show its potential as a helpful instrument in clinical practice. The PubMed database was searched for articles relating to the application of DTI in SCI. Relevant articles were also used for the review. A variety of DTI parameters have been studied in various articles. The standard parameters are fractional anisotropy (FA) values, apparent diffusion coefficient (ADC) values, radial diffusivity values, and axial diffusivity values, followed by tractography. FA and ADC values are the most commonly used parameters. The findings observed in most of the studies are increased FA and reduced ADC values following injury to the spinal cord. DTI data metrics possess the potential to become a potent clinical tool in patients with SCI. It is helpful for diagnosis, prognosis, treatment planning, as well as to evaluate the recovery. Nonetheless, to overcome the limitations and determine its reliability clinically, more research has to be performed.
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Affiliation(s)
- Akshada Atchut Kauthankar
- Department of Radio-diagnosis and Imaging, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
| | - M.M Jaseemudheen
- Department of Radio-diagnosis and Imaging, K S Hegde Medical Academy, Nitte (Deemed to be University), Mangalore, Karnataka, India
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Sadeghmousavi S, Soltani Khaboushan A, Jafarnezhad-Ansariha F, Nejad-Gashti R, Farsi M, Esmaeil-Pour R, Alijani M, Majidi Zolbin M, Niknejad H, Kajbafzadeh AM. The role of spinal cord tractography in detecting lesions following selective bladder afferent and efferent fibers: A novel method for induction of neurogenic lower urinary tract dysfunction in rabbit. Neurourol Urodyn 2022; 41:1539-1552. [PMID: 35842827 DOI: 10.1002/nau.25009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 06/07/2022] [Accepted: 06/19/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Neurogenic lower urinary tract dysfunction (NLUTD), a challenging disorder, is defined by lack of bladder control due to the abnormalities in neural pathways and can be classified based on the location of lesions within the nervous system, thus investigating the neural pathways can help us to know the site of the lesion and specify the class of the NLUTD. Diffusion Tensor Imaging (DTI) tractography, a noninvasive advanced imaging method, is capable of detecting central nervous system pathologies, even if routine magnetic resonance imaging shows no abnormality. Accordingly, tractography is an ideal technique to evaluate patients with NLUTD and visualize the pathology site within the spine. This study aimed to introduce a novel method of spinal cord injury (SCI) to establish NLUTD in the rabbit and to investigate the potential of tractography in tracing neural tracts of the spinal cord in an induced NLUTD animal model. MATERIALS AND METHODS An animal model of NLUTD was induced through cauterization of the spinal cord at the level T12-L1 in 12 rabbits. Then rabbits were assessed via DTI, urodynamic studies (UDS), voiding cystourethrogram (VCUG), and pathology assessments using antineurofilament 200 (NF200) antibody, anti-S100, anti-Smooth Muscle Actin, anti-Myogenin, and anti-MyoD1. RESULTS The tractography visualized lesions within spinal cord fibers. DTI parameters including fractional anisotropy (FA) value and tract density were significantly decreased (FA: p-value = 0.01, Tract density: p-value = 0.05) after injury. The mean diffusivity (MD) was insignificantly increased compared to before the injury. Also, the results of UDS and pathology assessments corroborated that applying SCI and the establishment of the NLUTD model was completely successful. CONCLUSION In the present study, we investigated the auxiliary role of tractography in detecting the spinal cord lesions in the novel established rabbit model of NLUTD. The introduced method of NLUTD induction was without the leg's neurological deficit, easily applicable, low-cost, and was accompanied by minimal surgical preparation and a satisfactory survival rate in comparison with other SCI animal models.
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Affiliation(s)
- Shaghayegh Sadeghmousavi
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.,School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Alireza Soltani Khaboushan
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research Center, Tehran University of Medical Science, Tehran, Iran
| | - Fahimeh Jafarnezhad-Ansariha
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Nejad-Gashti
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Farsi
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Esmaeil-Pour
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Alijani
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Majidi Zolbin
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abdol-Mohammad Kajbafzadeh
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Pediatrics' Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran.,Pediatric Urology and Regenerative Medicine Research Center, Gene, Cell and Tissue Research Institute, Childern's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
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7
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Karamian BA, Siegel N, Nourie B, Serruya MD, Heary RF, Harrop JS, Vaccaro AR. The role of electrical stimulation for rehabilitation and regeneration after spinal cord injury. J Orthop Traumatol 2022; 23:2. [PMID: 34989884 PMCID: PMC8738840 DOI: 10.1186/s10195-021-00623-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 12/27/2021] [Indexed: 12/26/2022] Open
Abstract
Electrical stimulation is used to elicit muscle contraction and can be utilized for neurorehabilitation following spinal cord injury when paired with voluntary motor training. This technology is now an important therapeutic intervention that results in improvement in motor function in patients with spinal cord injuries. The purpose of this review is to summarize the various forms of electrical stimulation technology that exist and their applications. Furthermore, this paper addresses the potential future of the technology.
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Affiliation(s)
- Brian A Karamian
- Rothman Orthopaedic Institute at Thomas Jefferson University, 925 Chestnut St, 5th Floor, Philadelphia, PA, 19107, USA.
| | - Nicholas Siegel
- Rothman Orthopaedic Institute at Thomas Jefferson University, 925 Chestnut St, 5th Floor, Philadelphia, PA, 19107, USA
| | - Blake Nourie
- Rothman Orthopaedic Institute at Thomas Jefferson University, 925 Chestnut St, 5th Floor, Philadelphia, PA, 19107, USA
| | | | - Robert F Heary
- Department of Neurological Surgery, Hackensack Meridian School of Medicine, Nutley, NJ, 07110, USA
| | - James S Harrop
- Thomas Jefferson University, Philadelphia, PA, 19107, USA
| | - Alexander R Vaccaro
- Rothman Orthopaedic Institute at Thomas Jefferson University, 925 Chestnut St, 5th Floor, Philadelphia, PA, 19107, USA
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8
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Biktimirov A, Pak O, Bryukhovetskiy I, Sharma A, Sharma HS. Neuromodulation as a basic platform for neuroprotection and repair after spinal cord injury. PROGRESS IN BRAIN RESEARCH 2021; 266:269-300. [PMID: 34689861 DOI: 10.1016/bs.pbr.2021.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Spinal cord injury (SCI) is one of the most challenging medical issues. Spasticity is a major complication of SCI. A combination of spinal cord stimulation, new methods of neuroprotection and biomedical cellular products provides fundamentally new options for SCI treatment and rehabilitation. The paper attempts to critically analyze the effectiveness of using these procedures for patients with SCI, suggesting a protocol for a step-by-step personalized treatment of SCI, based on continuity of modern conservative and surgical methods. The study argues the possibility of using neuromodulation as a basis for rehabilitating patients with SCI.
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Affiliation(s)
- Artur Biktimirov
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia.
| | - Oleg Pak
- Department of Neurosurgery, Medical Center, Far Eastern Federal University, Vladivostok, Russia
| | - Igor Bryukhovetskiy
- Department of Fundamental Medicine, School of Biomedicine, Far Eastern Federal University, Vladivostok, Russia
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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9
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Zhu F, Liu Y, Zeng L, Wang Y, Kong X, Yao S, Chen K, Jing X, Yang L, Guo X. Evaluating the Severity and Prognosis of Acute Traumatic Cervical Spinal Cord Injury: A Novel Classification Using Diffusion Tensor Imaging and Diffusion Tensor Tractography. Spine (Phila Pa 1976) 2021; 46:687-694. [PMID: 33395024 DOI: 10.1097/brs.0000000000003923] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective observational cohort study. OBJECTIVE We explored the relationship between diffusion tensor imaging (DTI) parameters and prognosis in patients with acute traumatic cervical spinal cord injury (ATCSCI). SUMMARY OF BACKGROUND DATA DTI has been used to diagnose spinal cord injury; nevertheless, its role remains controversial. METHODS We analyzed retrospectively 24 patients with ATCSCI who were examined using conventional T2-weighted imaging and DTI. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were recorded at the injured site. Diffusion tensor tractography (DTT) was used to measure the spinal cord white matter fiber volume (MWFV). American Spinal Injury Association (ASIA) grades were recorded. Correlations between DTI parameters and ASIA scores were evaluated using Spearman correlation coefficients. RESULTS FA values at injured sites were significantly lower than those of the control group, whereas ADC values in injured and control groups were not significantly different. DTT revealed that ATCSCI could be divided into four types: Type A1-complete rupture of spinal cord white matter fiber (MWF); Type A2-partial rupture of MWF; Type B-most MWF retained with severe compression or abnormal fiber conduction direction; and Type C-MWF basically complete with slight compression. Preoperative physical examinations revealed complete injury (ASIA A) in patients with A1 (n = 4) and A2 (n = 4). The ASIA grades or scores of A2 were improved to varying degrees, whereas there was no significant improvement in A1. FA values and MWFV of ASIA B, C, and D were significantly higher than those of ASIA A. FA and MWFV were correlated with ASIA motor score preoperatively and at final follow-up. CONCLUSION We propose a classification for the severity of ATCSCI based on DTI and DTT that may explain why some patients with ASIA A recover, whereas others do not.Level of Evidence: 4.
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Affiliation(s)
- Fengzhao Zhu
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Liu
- Department of Radiology, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lian Zeng
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yulong Wang
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiangchuang Kong
- Department of Radiology, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Yao
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kaifang Chen
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xirui Jing
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lian Yang
- Department of Radiology, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaodong Guo
- Department of Orthopedics, Union hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Cheng SJ, Tsai PH, Lee YT, Li YT, Chung HW, Chen CY. Diffusion Tensor Imaging of the Spinal Cord. Magn Reson Imaging Clin N Am 2021; 29:195-204. [PMID: 33902903 DOI: 10.1016/j.mric.2021.02.002] [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] [Indexed: 01/11/2023]
Abstract
Spinal cord often is regarded as one of the last territories in the central nervous system where diffusion tensor imaging (DTI) can be used to probe white matter architecture. This article reviews current progress in spinal cord DTI, starting with anatomic properties and technical challenges that make spinal cord DTI a difficult task. Several possibilities offered by advanced pulse sequences that might overcome the difficulties are addressed, with associated trade-offs and limitations. Potential clinical assistance also is discussed in various spinal cord pathologies, such as myelopathy due to external compression, spinal cord tumors, acute ischemia, traumatic injury, and so forth.
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Affiliation(s)
- Sho-Jen Cheng
- Department of Medical Imaging, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
| | - Ping-Huei Tsai
- Department of Medical Imaging and Radiological Sciences, Chung-Shan Medical University, No.110, Sec.1, Jianguo N. Road, Taichung 40201, Taiwan
| | - Yun-Ting Lee
- Translational Imaging Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
| | - Yi-Tien Li
- Translational Imaging Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan
| | - Hsiao-Wen Chung
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, No.1, Sec.4, Roosevelt Road, Taipei 10617, Taiwan; Department of Electrical Engineering, National Taiwan University, No.1, Sec.4, Roosevelt Road, Taipei 10617, Taiwan.
| | - Cheng-Yu Chen
- Department of Medical Imaging, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan; Translational Imaging Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110, Taiwan
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Zhu F, Zeng L, Gui S, Liu Y, Wang Y, Cao X, Lin H, Yang L, Kong X, Guo X. The Role of Diffusion Tensor Imaging and Diffusion Tensor Tractography in the Assessment of Acute Traumatic Thoracolumbar Spinal Cord Injury. World Neurosurg 2021; 150:e23-e30. [PMID: 33561552 DOI: 10.1016/j.wneu.2021.01.146] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/27/2021] [Accepted: 01/28/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND This study explored diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) to assess the prognosis of thoracolumbar spinal cord injury (SCI). METHODS Twenty patients with acute traumatic thoracolumbar complete SCI (T1-L1, American Spinal Injury Association Impairment Scale [AIS] grade A) underwent conventional magnetic resonance imaging and DTI examinations. DTI measured the fractional anisotropy (FA) and apparent diffusion coefficient adjacent to the lesion epicenter. DTT was used to detect the white matter fiber morphology and measure the imaginary white matter fiber volume and connection rates of fiber tractography (CRFT). The patients' neurological functions were evaluated by the AIS grades. RESULTS At the final-follow-up, among the 20 patients with AIS grade A, 15 maintained the AIS grade (group A), and 5 patients showed improvement of AIS grade (group B). Group A's mean FA value was significantly lower than that of group B, whereas the mean apparent diffusion coefficient value among the 2 groups showed no significant difference. The white matter fibers of most patients in group A were completely ruptured (11/15), but the white matter fibers of all patients in group B were retained in different number (5/5). The mean CRFT of group B was significantly higher than that of group A (P < 0.05). The improvement of AIS grade was slightly positively correlated with FA values and highly positively correlated with CRFT. CONCLUSIONS The prognosis of complete thoracolumbar SCI may be related to the FA value and the CRFT. The application of DTI and DTT may optimize the diagnosis of thoracolumbar SCI.
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Affiliation(s)
- Fengzhao Zhu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Lian Zeng
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Shan Gui
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yuan Liu
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yulong Wang
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaojian Cao
- Department of Spine Surgery, Jiangsu Province Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing, Jiangsu, China
| | - Haodong Lin
- Department of Orthopaedics, Shanghai First People's Hospital, Shanghai Jiaotong University First People's Hospital, Shanghai, China
| | - Lian Yang
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiangchuang Kong
- Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaodong Guo
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Dauleac C, Bannier E, Cotton F, Frindel C. Effect of distortion corrections on the tractography quality in spinal cord diffusion-weighted imaging. Magn Reson Med 2021; 85:3241-3255. [PMID: 33475180 DOI: 10.1002/mrm.28665] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To assess the impact of a different distortion correction (DC) method and patient geometry (sagittal balance) on the quality of spinal cord tractography rendering according to different tractography approaches. METHODS Forty-four adults free of spinal cord diseases underwent cervical diffusion-weighted imaging. The phase-encoding direction was head→foot. Sequence with opposed polarities (foot→head) was acquired to perform DC. Eddy-current, motion effects, and susceptibility artifact correction methods were used for DC, and two deterministic and one probabilistic tractography approaches were evaluated using MRtrix and DSI Studio tractography software. Fiber length and number of fibers were extracted to evaluate the quality of the tractography rendering. For each subject, cervical lordosis was measured to assess patient geometry. The angle between the main direction of the spinal cord and the orientation of the acquisition box were computed at each spine level to assess acquisition geometry and define an angle threshold for which a tractography of good quality is no longer possible. RESULTS There was a significant improvement in tractography quality after performing DC with susceptibility artifact correction using a deterministic approach based on tensor. Before DC, the angle threshold was defined at C6 (15.2°) compared with C7 (21.9°) after corrections, demonstrating the importance of spinal cord angulation for DC. CONCLUSION The impact of DC on tractography quality is greatly impacted by acquisition geometry. To obtain a good-quality tractography, we propose as a future perspective to adapt the acquisition geometry to that of the patient by automatically adjusting the acquisition box.
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Affiliation(s)
- Corentin Dauleac
- Department of Neurosurgery, Hôpital neurologique et neurochirurgical Pierre Wertheimer, Hospices Civils de Lyon, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon I, Lyon, France.,Laboratoire CREATIS, CNRS UMR5220, INSA-Lyon, Université de Lyon I, Inserm U1206, Lyon, France
| | - Elise Bannier
- Université de Rennes, Inria, CNRS, Inserm, IRISA UMR 6074, Empenn, France.,Department of Radiology, CHU de Rennes, Rennes, France
| | - François Cotton
- Université de Lyon, Université Claude Bernard Lyon I, Lyon, France.,Laboratoire CREATIS, CNRS UMR5220, INSA-Lyon, Université de Lyon I, Inserm U1206, Lyon, France.,Department of Radiology, Centre Hospitalier de Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Carole Frindel
- Université de Lyon, Université Claude Bernard Lyon I, Lyon, France.,Laboratoire CREATIS, CNRS UMR5220, INSA-Lyon, Université de Lyon I, Inserm U1206, Lyon, France
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Irimia A, Van Horn JD. Mapping the rest of the human connectome: Atlasing the spinal cord and peripheral nervous system. Neuroimage 2021; 225:117478. [PMID: 33160086 PMCID: PMC8485987 DOI: 10.1016/j.neuroimage.2020.117478] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 09/15/2020] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
The emergence of diffusion, structural, and functional neuroimaging methods has enabled major multi-site efforts to map the human connectome, which has heretofore been defined as containing all neural connections in the central nervous system (CNS). However, these efforts are not structured to examine the richness and complexity of the peripheral nervous system (PNS), which arguably forms the (neglected) rest of the connectome. Despite increasing interest in an atlas of the spinal cord (SC) and PNS which is simultaneously stereotactic, interactive, electronically dissectible, scalable, population-based and deformable, little attention has thus far been devoted to this task of critical importance. Nevertheless, the atlasing of these complete neural structures is essential for neurosurgical planning, neurological localization, and for mapping those components of the human connectome located outside of the CNS. Here we recommend a modification to the definition of the human connectome to include the SC and PNS, and argue for the creation of an inclusive atlas to complement current efforts to map the brain's human connectome, to enhance clinical education, and to assist progress in neuroscience research. In addition to providing a critical overview of existing neuroimaging techniques, image processing methodologies and algorithmic advances which can be combined for the creation of a full connectome atlas, we outline a blueprint for ultimately mapping the entire human nervous system and, thereby, for filling a critical gap in our scientific knowledge of neural connectivity.
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Affiliation(s)
- Andrei Irimia
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, 3715 McClintock Avenue, Los Angeles CA 90089, United States; Corwin D. Denney Research Center, Department of Biomedical Engineering, Viterbi School of Engineering, University of Southern California, 1042 Downey Way, Los Angeles, CA 90089, United States.
| | - John Darrell Van Horn
- Department of Psychology, University of Virginia, 485 McCormick Road, Gilmer Hall, Room 102, Charlottesville, Virginia 22903, United States; School of Data Science, University of Virginia, Dell 1, Charlottesville, Virginia 22903, United States.
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14
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Dauleac C, Frindel C, Mertens P, Jacquesson T, Cotton F. Overcoming challenges of the human spinal cord tractography for routine clinical use: a review. Neuroradiology 2020; 62:1079-1094. [DOI: 10.1007/s00234-020-02442-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 04/16/2020] [Indexed: 02/06/2023]
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15
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Spinal cord stimulation and intrathecal baclofen therapy for patients with severe spasticity after spinal cord injury. PROGRESS IN BRAIN RESEARCH 2020; 258:79-99. [DOI: 10.1016/bs.pbr.2020.09.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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16
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Alizadeh M, Kozlowski L, Muller J, Ashraf N, Shahrampour S, Mohamed FB, Wu C, Sharan A. Hemispheric Regional Based Analysis of Diffusion Tensor Imaging and Diffusion Tensor Tractography in Patients with Temporal Lobe Epilepsy and Correlation with Patient outcomes. Sci Rep 2019; 9:215. [PMID: 30659215 PMCID: PMC6338779 DOI: 10.1038/s41598-018-36818-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/16/2018] [Indexed: 11/09/2022] Open
Abstract
Imaging in the field of epilepsy surgery remains an essential tool in terms of its ability to identify regions where the seizure focus might present as a resectable area. However, in many instances, an obvious structural abnormality is not visualized. This has created the opportunity for new approaches and imaging innovation in the field of epilepsy, such as with Diffusion Tensor Imaging (DTI) and Diffusion Tensor Tractography (DTT). In this study, we aim to evaluate the use of DTI and DTT as a predictive model in the field of epilepsy, specifically Temporal Lobe Epilepsy (TLE), and correlate their clinical significance with respect to postsurgical outcomes. A hemispheric based analysis was used to compare the tract density, as well as DTI indices of the specific regions of interest from the pathologic hemisphere to the healthy hemisphere in TLE patients. A total of 22 patients with TLE (12 males, 10 females, 22–57 age range) underwent either a craniotomy, Anterior Temporal Lobectomy (ATL), or a less invasive method of Selective Laser Amygdalohippocampectomy (SLAH) and were imaged using 3.0 T Philips Achieva MR scanner. Of the participants, 12 underwent SLAH while 10 underwent ATL. The study was approved by the institutional review board of Thomas Jefferson University Hospital. Informed consent was obtained from all patients. All patients had a diagnosis of TLE according to standard clinical criteria. DTI images were acquired axially in the same anatomical location prescribed for the T1-weighted images. The raw data set consisting of diffusion volumes were first corrected for eddy current distortions and motion artifacts. Various DTI indices such as Fractional Anisotropy (FA), Mean Diffusivity (MD), Radial Diffusivity (RD) and Axial Diffusivity (AD) were estimated and co-registered to the brain parcellation map obtained by freesurfer. 16 consolidated cortical and subcortical regions were selected as regions of interest (ROIs) by a functional neurosurgeon and DTI values for each ROI were calculated and compared with the corresponding ROI in the opposite hemisphere. Also, track density imaging (TDI) of 68 white matter parcels were generated using fiber orientation distribution (FOD) based deterministic fiber tracking and compared with contralateral side of the brain in each epileptic group: left mesial temporal sclerosis (LMTS) and right MTS (RMTS)). In patients with LMTS, MD and RD values of the left hippocampus decreased significantly using two-tailed t-test (p = 0.03 and p = 0.01 respectively) compared to the right hippocampus. Also, RD showed a marginally significant decrease in left amygdala (p = 0.05). DTT analysis in LMTS shows a marginally significant decrease in the left white matter supramarginal parcel (p = 0.05). In patients with RMTS, FA showed a significant decrease in the ipsilateral mesial temporal lobe (p = 0.02), parahippocampal area (p = 0.03) and thalamus (p = 0.006). RD showed a marginally significant increase in the ipsilateral hippocampus (p = 0.05) and a significant increase in the ipsilateral parahippocampal area (p = 0.03). Also, tract density of the ipsilateral white matter inferior parietal parcel showed a marginally significant increase compared to the contralateral side (p = 0.05). With respect to postsurgical outcomes, we found an association between residual seizures and tract density in five white matter segments including ipsilateral lingual (p = 0.04), ipsilateral temporal pole (p = 0.007), ipsilateral pars opercularis (p = 0.03), ipsilateral inferior parietal (p = 0.04) and contralateral frontal pole (p = 0.04). These results may have the potential to be developed into imaging prognostic markers of postoperative outcomes and provide new insights for why some patients with TLE continue to experience postoperative seizures if pathological/clinical correlates are further confirmed.
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Affiliation(s)
- Mahdi Alizadeh
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA. .,Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA.
| | - Lauren Kozlowski
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jennifer Muller
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.,Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Neha Ashraf
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA
| | - Shiva Shahrampour
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Feroze B Mohamed
- Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Chengyuan Wu
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.,Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Ashwini Sharan
- Department of Neurosurgery, Thomas Jefferson University, Philadelphia, PA, USA.,Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, PA, USA
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Diffusion tensor imaging (DTI) and Tractography of the spinal cord in pediatric population with spinal lipomas: preliminary study. Childs Nerv Syst 2019; 35:129-137. [PMID: 30073389 DOI: 10.1007/s00381-018-3935-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Accepted: 07/25/2018] [Indexed: 01/15/2023]
Abstract
PURPOSE Diffusion tensor imaging (DTI) allows studying the micro and macro architecture. One of the major challenges in dysraphism is to know the morphologic organization of the spinal cord. In a preliminary work, spinal lipoma was chosen for analyzing the micro-architecture parameters and fiber morphology of the spinal cord by DTI with tractography. METHODS Twelve patients (0-8 years) related to spinal lipomas treated between May 2017 and March 2018 were included. Tractography reconstruction of the conus medullaris of 12 patients were obtained using the MedINRIA software. The diffusion parameters have been calculated by Osirix DTImap plugin. RESULTS We found a significant difference in the FA (p = 0.024) between two age groups (< 24 months old and > 24 months old). However, no significant differences in the mean values of FA, RD, and MD between the level of the lipoma and the level above were noted. The tractography obtained in each case was coherent with morphologic sequences and reproducible. The conus medullaris was deformed and shifted. Destruction or disorganization of fibers and any passing inside the lipomas was not observed. CONCLUSIONS Tractography of the conus medullaris in a very young pediatric population (0-8 years old) with a spinal lipoma is possible, reproductive, and allows visualization of the spinal cord within the dysraphism. Analysis of the FA shows that the presence of a lipoma seems to have an effect on the myelination of the conus medullaris. It is during the probable myelination phase that the majority of symptoms appear. Is the myelination per se the cause?
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Hu J, Li M, Dai Y, Geng C, Tong B, Zhou Z, Liang X, Yang W, Zhang B. Combining SENSE and reduced field-of-view for high-resolution diffusion weighted magnetic resonance imaging. Biomed Eng Online 2018; 17:77. [PMID: 29903023 PMCID: PMC6003092 DOI: 10.1186/s12938-018-0511-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 06/05/2018] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND In diffusion-weighted magnetic resonance imaging (DWI) using single-shot echo planar imaging (ss-EPI), both reduced field-of-view (FOV) excitation and sensitivity encoding (SENSE) alone can increase in-plane resolution to some degree. However, when the two techniques are combined to further increase resolution without pronounced geometric distortion, the resulted images are often corrupted by high level of noise and artifact due to the numerical restriction in SENSE. Hence, this study is aimed to provide a reconstruction method to deal with this problem. METHODS The proposed reconstruction method was developed and implemented to deal with the high level of noise and artifact in the combination of reduced FOV imaging and traditional SENSE, in which all the imaging data were considered jointly by incorporating the motion induced phase variations among excitations. The in vivo human spine diffusion images from ten subjects were acquired at 1.5 T and reconstructed using the proposed method, and compared with SENSE magnitude average results for a range of reduction factors in reduced FOV. These images were evaluated by two radiologists using visual scores (considering distortion, noise and artifact levels) from 1 to 10. RESULTS The proposed method was able to reconstruct images with greatly reduced noise and artifact compared to SENSE magnitude average. The mean g-factors were maintained close to 1 along with enhanced signal-to-noise ratio efficiency. The image quality scores of the proposed method were significantly higher (P < 0.01) than SENSE magnitude average for all the evaluated reduction factors. CONCLUSION The proposed method can improve the combination of SENSE and reduced FOV for high-resolution ss-EPI DWI with reduced noise and artifact.
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Affiliation(s)
- Jisu Hu
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Ming Li
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China
| | - Yakang Dai
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Chen Geng
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Baotong Tong
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Zhiyong Zhou
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, Jiangsu, China
| | - Xue Liang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China
| | - Wen Yang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China
| | - Bing Zhang
- Department of Radiology, Affiliated Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing, Jiangsu, China.
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19
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Zhang C, Chen K, Han X, Fu J, Douglas P, Morozova AY, Abakumov MA, Gubsky IL, Li D, Guo J, Zhang X, Wang G, Chekhonin VP. Diffusion Tensor Imaging in Diagnosis of Post-Traumatic Syringomyelia in Spinal Cord Injury in Rats. Med Sci Monit 2018; 24:177-182. [PMID: 29311540 PMCID: PMC5771161 DOI: 10.12659/msm.907955] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background Post-traumatic syringomyelia (PTS) is a common disease after spinal cord injury (SCI). The present study was performed to evaluate the advantages of diffusion tensor imaging (DTI) in estimating SCI and prognosing PTS in SCI rats. Material/Methods Forty rats were divided into 3 groups based on the extent of the individual SCI and PTS: a control group (n=10), a PTS group (n=8), and an SCI group (n=22). BBB tests were performed preoperatively and postoperatively at (1 d, 3 d, 5 d, 1 w, 2 w, 1 w, 2 w, 3 w, 4 w, 5 w, and 6 w). MRI T2 scanning was conducted postoperatively at (1 w, 2 w, 3 w, 4 w, 5 w, 6 w). DTI and diffusion tensor tractography were used for analyzing neuro-fiber changes after SCI. Results BBB scoring showed no differences between the PTS group and SCI group (P<0.05). PTS was found in 8 rats after SCI. MRI showed PTS formation in 3 rats at 2 w after SCI, and 5 rats showed PTS formation at postoperative 3w after SCI. Compared with the control group, ADC showed significant increase in both the PTS group (P<0.05) and the SCI group (P<0.05), FA showed significant decreases in the PTS (P<0.05) and SCI (P<0.05) groups. Compared with the SCI group, the PTS group showed an increase in ADC, but no statistical difference was found in ADC (P>0.05). The PTS group showed a significant increase in FA (P<0.05). Conclusions The combination of diffusion tensor imaging and diffusion tensor tractography has characteristics of high-sensitivity and quantitation for PTS prognosis. FA is predictive in the prognosis of PTS formation after SCI.
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Affiliation(s)
- Chao Zhang
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland).,Department of Medicinal Nanobiotechnology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Kai Chen
- Department of Radiology, The Second Hospital of Tianjin Medical University, Tianjin, China (mainland).,Department of Tumor Intervention, Tianjin 4th Centre Hospital, Tianjin, China (mainland)
| | - Xiuxin Han
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| | | | | | - Anna Y Morozova
- Department of Basic and Applied Neurobiology, Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russian Federation
| | - Maxim A Abakumov
- Department of Medicinal Nanobiotechnology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Ilya L Gubsky
- Department of Medicinal Nanobiotechnology, Pirogov Russian National Research Medical University, Moscow, Russian Federation
| | - Dejin Li
- Tianjin Key Laboratory for Prevention and Control of Occupational and Environmental Hazards, Logistics University of The People's Armed Police Force, Tianjin, China (mainland)
| | - Jin Guo
- Tianjin Key Laboratory for Prevention and Control of Occupational and Environmental Hazards, Logistics University of The People's Armed Police Force, Tianjin, China (mainland)
| | - Xuening Zhang
- Department of Tumor Intervention, Tianjin 4th Centre Hospital, Tianjin, China (mainland)
| | - Guowen Wang
- Department of Bone and Soft Tissue Tumors, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, China (mainland)
| | - Vladimir P Chekhonin
- Department of Medicinal Nanobiotechnology, Pirogov Russian National Research Medical University, Moscow, Russian Federation.,Department of Basic and Applied Neurobiology, Federal Medical Research Center for Psychiatry and Narcology, Moscow, Russian Federation
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