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000140092 041__ $$aEnglish
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000140092 1001_ $$0P:(DE-2719)2814076$$aZiegler, Gabriel$$b0$$eFirst author$$udzne
000140092 245__ $$aProgressive neurodegeneration following spinal cord injury: Implications for clinical trials.
000140092 260__ $$a[S.l.]$$bOvid$$c2018
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000140092 520__ $$aTo quantify atrophy, demyelination, and iron accumulation over 2 years following acute spinal cord injury and to identify MRI predictors of clinical outcomes and determine their suitability as surrogate markers of therapeutic intervention.We assessed 156 quantitative MRI datasets from 15 patients with spinal cord injury and 18 controls at baseline and 2, 6, 12, and 24 months after injury. Clinical recovery (including neuropathic pain) was assessed at each time point. Between-group differences in linear and nonlinear trajectories of volume, myelin, and iron change were estimated. Structural changes by 6 months were used to predict clinical outcomes at 2 years.The majority of patients showed clinical improvement with recovery stabilizing at 2 years. Cord atrophy decelerated, while cortical white and gray matter atrophy progressed over 2 years. Myelin content in the spinal cord and cortex decreased progressively over time, while cerebellar loss decreases decelerated. As atrophy progressed in the thalamus, sustained iron accumulation was evident. Smaller cord and cranial corticospinal tract atrophy, and myelin changes within the sensorimotor cortices, by 6 months predicted recovery in lower extremity motor score at 2 years. Whereas greater cord atrophy and microstructural changes in the cerebellum, anterior cingulate cortex, and secondary sensory cortex by 6 months predicted worse sensory impairment and greater neuropathic pain intensity at 2 years.These results draw attention to trauma-induced neuroplastic processes and highlight the intimate relationships among neurodegenerative processes in the cord and brain. These measurable changes are sufficiently large, systematic, and predictive to render them viable outcome measures for clinical trials.
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000140092 650_2 $$2MeSH$$aAdult
000140092 650_2 $$2MeSH$$aAged
000140092 650_2 $$2MeSH$$aAtrophy
000140092 650_2 $$2MeSH$$aBrain: diagnostic imaging
000140092 650_2 $$2MeSH$$aBrain: pathology
000140092 650_2 $$2MeSH$$aDisease Progression
000140092 650_2 $$2MeSH$$aFemale
000140092 650_2 $$2MeSH$$aFollow-Up Studies
000140092 650_2 $$2MeSH$$aHumans
000140092 650_2 $$2MeSH$$aLongitudinal Studies
000140092 650_2 $$2MeSH$$aMale
000140092 650_2 $$2MeSH$$aMiddle Aged
000140092 650_2 $$2MeSH$$aNerve Degeneration: diagnostic imaging
000140092 650_2 $$2MeSH$$aNerve Degeneration: etiology
000140092 650_2 $$2MeSH$$aNerve Degeneration: physiopathology
000140092 650_2 $$2MeSH$$aNeuralgia: diagnostic imaging
000140092 650_2 $$2MeSH$$aNeuralgia: etiology
000140092 650_2 $$2MeSH$$aNeuralgia: physiopathology
000140092 650_2 $$2MeSH$$aNeurodegenerative Diseases: diagnostic imaging
000140092 650_2 $$2MeSH$$aNeurodegenerative Diseases: etiology
000140092 650_2 $$2MeSH$$aNeurodegenerative Diseases: physiopathology
000140092 650_2 $$2MeSH$$aRecovery of Function
000140092 650_2 $$2MeSH$$aSpinal Cord: diagnostic imaging
000140092 650_2 $$2MeSH$$aSpinal Cord: pathology
000140092 650_2 $$2MeSH$$aSpinal Cord Injuries: complications
000140092 650_2 $$2MeSH$$aSpinal Cord Injuries: diagnostic imaging
000140092 650_2 $$2MeSH$$aSpinal Cord Injuries: physiopathology
000140092 650_2 $$2MeSH$$aYoung Adult
000140092 7001_ $$aGrabher, Patrick$$b1
000140092 7001_ $$aThompson, Alan$$b2
000140092 7001_ $$aAltmann, Daniel$$b3
000140092 7001_ $$aHupp, Markus$$b4
000140092 7001_ $$aAshburner, John$$b5
000140092 7001_ $$aFriston, Karl$$b6
000140092 7001_ $$aWeiskopf, Nikolaus$$b7
000140092 7001_ $$aCurt, Armin$$b8
000140092 7001_ $$aFreund, Patrick$$b9
000140092 77318 $$2Crossref$$3journal-article$$a10.1212/wnl.0000000000005258$$b : Ovid Technologies (Wolters Kluwer Health), 2018-03-07$$n14$$pe1257-e1266$$tNeurology$$v90$$x0028-3878$$y2018
000140092 773__ $$0PERI:(DE-600)1491874-2$$a10.1212/WNL.0000000000005258$$gVol. 90, no. 14, p. e1257 - e1266$$n14$$pe1257-e1266$$q90:14<e1257 - e1266$$tNeurology$$v90$$x0028-3878$$y2018
000140092 8567_ $$2Pubmed Central$$uhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5890610
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