Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Lower Saxony, Germany.
Centre of Systems Neuroscience, Hannover, Lower Saxony, Germany.
J Transl Med. 2018 Sep 17;16(1):258. doi: 10.1186/s12967-018-1630-4.
Traumatic spinal cord injury (SCI) results in sensory and motor function impairment and may cause a substantial social and economic burden. For the implementation of novel treatment strategies, parallel development of objective tools evaluating spinal cord (SC) integrity during motor function recovery (MFR) is needed. Diffusion tensor imaging (DTI) enables in vivo microstructural assessment of SCI.
In the current study, temporal evolvement of DTI metrics during MFR were examined; therefore, values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in a population of 17 paraplegic dogs with naturally-occurring acute SCI showing MFR within 4 weeks after surgical decompression and compared to 6 control dogs. MRI scans were performed preoperatively and 12 weeks after MFR was observed. DTI metrics were obtained at the lesion epicentre and one SC segment cranially and caudally. Variance analyses were performed to compare values between evaluated localizations in affected dogs and controls and between time points. Correlations between DTI metrics and clinical scores at follow-up examinations were assessed.
Before surgery, FA values at epicentres were higher than caudally (p = 0.0014) and control values (p = 0.0097); ADC values were lower in the epicentre compared to control values (p = 0.0035) and perilesional (p = 0.0448 cranially and p = 0.0433 caudally). In follow-up examinations, no significant differences could be found between DTI values from dogs showing MFR and control dogs. Lower ADC values at epicentres correlated with neurological deficits at follow-up examinations (r = - 0.705; p = 0.0023).
Findings suggest that a tendency to the return of DTI values to the physiological situation after surgical decompression accompanies MFR after SCI in paraplegic dogs. DTI may represent a useful and objective clinical tool for follow-up studies examining in vivo SC recovery in treatment studies.
外伤性脊髓损伤（SCI）会导致感觉和运动功能障碍，并可能造成巨大的社会和经济负担。为了实施新的治疗策略，需要同时开发客观的工具来评估脊髓（SC）在运动功能恢复（MFR）过程中的完整性。弥散张量成像（DTI）可实现 SCI 的体内微观结构评估。
在目前的研究中，我们研究了 MFR 过程中 DTI 指标的时间演变，因此，在 17 只自然发生急性 SCI 的截瘫犬中测量了部分各向异性分数（FA）和表观扩散系数（ADC）值，这些犬在手术后减压 4 周内表现出 MFR，并与 6 只对照犬进行了比较。在 MFR 观察后 12 周进行 MRI 扫描。在病变中心和一个 SC 节段的头侧和尾侧获得 DTI 指标。方差分析用于比较受影响犬和对照组以及不同时间点之间的评估部位的数值。评估 DTI 指标与随访检查时临床评分之间的相关性。
在手术前，病变中心的 FA 值高于尾侧（p=0.0014）和对照组（p=0.0097）；与对照组（p=0.0035）和病变周围（p=0.0448 头侧和 p=0.0433 尾侧）相比，病变中心的 ADC 值较低。在随访检查中，表现出 MFR 的犬与对照组犬的 DTI 值之间没有发现显著差异。病变中心较低的 ADC 值与随访检查中的神经功能缺损相关（r=-0.705；p=0.0023）。
研究结果表明，在 SCI 截瘫犬减压后，手术减压后 DTI 值有恢复到生理状态的趋势，这与 MFR 有关。DTI 可能代表一种有用的客观临床工具，可用于研究治疗后活体 SC 恢复的随访研究。
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