Ambulatory function in motor incomplete spinal cord injury: A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry

A. C. Smith; K. A. Weber; T. B. Parrish; T. G. Hornby; V. M. Tysseling; J. G. McPherson; M. Wasielewski; J. M. Elliott

doi:10.1038/sc.2017.18

Ambulatory function in motor incomplete spinal cord injury: A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry

A. C. Smith^*, K. A. Weber, T. B. Parrish, T. G. Hornby, V. M. Tysseling, J. G. McPherson, M. Wasielewski, J. M. Elliott

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

21 Scopus citations

Abstract

Study design: This research utilized a cross-sectional design.Objectives: Spinal cord edema length has been measured with T2-weighted sagittal MRI to predict motor recovery following spinal cord injury. The purpose of our study was to establish the correlational value of axial spinal cord edema using T2-weighted MRI. We hypothesized a direct relationship between the size of damage on axial MRI and walking ability, motor function and distal muscle changes seen in motor incomplete spinal cord injury (iSCI).Setting: University-based laboratory in Chicago, IL, USA.Methods: Fourteen participants with iSCI took part in the study. Spinal cord axial damage ratios were assessed using axial T2-weighted MRI. Walking ability was investigated using the 6-min walk test and daily stride counts. Maximum plantarflexion torque was quantified using isometric dynomometry. Muscle fat infiltration (MFI) and relative muscle cross-sectional area (rmCSA) were quantified using fat/water separation magnetic resonance imaging.Results: Damage ratios were negatively correlated with distance walked in 6 min, average daily strides and maximum plantarflexion torque, and a negative linear trend was found between damage ratios and lower leg rmCSA. While damage ratios were not significantly correlated with MFI, we found significantly higher MFI in the wheelchair user participant group compared to community walkers.Conclusions: Damage ratios may be useful in prognosis of motor recovery in spinal cord injury. The results warrant a large multi-site research study to investigate the value of high-resolution axial T2-weighted imaging to predict walking recovery following motor incomplete spinal cord injury.

Original language	English (US)
Pages (from-to)	672-678
Number of pages	7
Journal	Spinal Cord
Volume	55
Issue number	7
DOIs	https://doi.org/10.1038/sc.2017.18
State	Published - Jul 1 2017

Funding

We thank all participants for their willingness to take part in this study. We thank Mark A Hoggarth for his assistance with the MatLab programming used to analyze the MFI data, and we thank Gordhan Mahtani and Mark Connolly for their assistance with participant recruitment and data collection. JME is supported by the NIH award 1 R01HD079076-01A1, entitled 'Neuromuscular Mechanisms Underlying Poor Recovery from Whiplash Injuries'. ACS is supported by the NIH Extramural Loan Repayment Program for Clinical Researchers funded by the National Institute of Neurological Disorders and Stroke, and by the Foundation for Physical Therapy Promotion of Doctoral Studies programs. KAW is supported by the Interdisciplinary Research Training in Pain and Substance Use Disorders T32DA035165 funded by the National Institute on Drug Abuse. This research was conceptualized and carried out at Northwestern University

ASJC Scopus subject areas

Clinical Neurology
Neurology
Rehabilitation

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10.1038/sc.2017.18

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@article{db455ef7e0cb4fd1a54795d58751e7f4,

title = "Ambulatory function in motor incomplete spinal cord injury: A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry",

abstract = "Study design: This research utilized a cross-sectional design.Objectives: Spinal cord edema length has been measured with T2-weighted sagittal MRI to predict motor recovery following spinal cord injury. The purpose of our study was to establish the correlational value of axial spinal cord edema using T2-weighted MRI. We hypothesized a direct relationship between the size of damage on axial MRI and walking ability, motor function and distal muscle changes seen in motor incomplete spinal cord injury (iSCI).Setting: University-based laboratory in Chicago, IL, USA.Methods: Fourteen participants with iSCI took part in the study. Spinal cord axial damage ratios were assessed using axial T2-weighted MRI. Walking ability was investigated using the 6-min walk test and daily stride counts. Maximum plantarflexion torque was quantified using isometric dynomometry. Muscle fat infiltration (MFI) and relative muscle cross-sectional area (rmCSA) were quantified using fat/water separation magnetic resonance imaging.Results: Damage ratios were negatively correlated with distance walked in 6 min, average daily strides and maximum plantarflexion torque, and a negative linear trend was found between damage ratios and lower leg rmCSA. While damage ratios were not significantly correlated with MFI, we found significantly higher MFI in the wheelchair user participant group compared to community walkers.Conclusions: Damage ratios may be useful in prognosis of motor recovery in spinal cord injury. The results warrant a large multi-site research study to investigate the value of high-resolution axial T2-weighted imaging to predict walking recovery following motor incomplete spinal cord injury.",

author = "Smith, {A. C.} and Weber, {K. A.} and Parrish, {T. B.} and Hornby, {T. G.} and Tysseling, {V. M.} and McPherson, {J. G.} and M. Wasielewski and Elliott, {J. M.}",

note = "Funding Information: We thank all participants for their willingness to take part in this study. We thank Mark A Hoggarth for his assistance with the MatLab programming used to analyze the MFI data, and we thank Gordhan Mahtani and Mark Connolly for their assistance with participant recruitment and data collection. JME is supported by the NIH award 1 R01HD079076-01A1, entitled 'Neuromuscular Mechanisms Underlying Poor Recovery from Whiplash Injuries'. ACS is supported by the NIH Extramural Loan Repayment Program for Clinical Researchers funded by the National Institute of Neurological Disorders and Stroke, and by the Foundation for Physical Therapy Promotion of Doctoral Studies programs. KAW is supported by the Interdisciplinary Research Training in Pain and Substance Use Disorders T32DA035165 funded by the National Institute on Drug Abuse. This research was conceptualized and carried out at Northwestern University Publisher Copyright: {\textcopyright} 2017 International Spinal Cord Society.",

year = "2017",

month = jul,

day = "1",

doi = "10.1038/sc.2017.18",

language = "English (US)",

volume = "55",

pages = "672--678",

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T1 - Ambulatory function in motor incomplete spinal cord injury

T2 - A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry

AU - Smith, A. C.

AU - Weber, K. A.

AU - Parrish, T. B.

AU - Hornby, T. G.

AU - Tysseling, V. M.

AU - McPherson, J. G.

AU - Wasielewski, M.

AU - Elliott, J. M.

N1 - Funding Information: We thank all participants for their willingness to take part in this study. We thank Mark A Hoggarth for his assistance with the MatLab programming used to analyze the MFI data, and we thank Gordhan Mahtani and Mark Connolly for their assistance with participant recruitment and data collection. JME is supported by the NIH award 1 R01HD079076-01A1, entitled 'Neuromuscular Mechanisms Underlying Poor Recovery from Whiplash Injuries'. ACS is supported by the NIH Extramural Loan Repayment Program for Clinical Researchers funded by the National Institute of Neurological Disorders and Stroke, and by the Foundation for Physical Therapy Promotion of Doctoral Studies programs. KAW is supported by the Interdisciplinary Research Training in Pain and Substance Use Disorders T32DA035165 funded by the National Institute on Drug Abuse. This research was conceptualized and carried out at Northwestern University Publisher Copyright: © 2017 International Spinal Cord Society.

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Study design: This research utilized a cross-sectional design.Objectives: Spinal cord edema length has been measured with T2-weighted sagittal MRI to predict motor recovery following spinal cord injury. The purpose of our study was to establish the correlational value of axial spinal cord edema using T2-weighted MRI. We hypothesized a direct relationship between the size of damage on axial MRI and walking ability, motor function and distal muscle changes seen in motor incomplete spinal cord injury (iSCI).Setting: University-based laboratory in Chicago, IL, USA.Methods: Fourteen participants with iSCI took part in the study. Spinal cord axial damage ratios were assessed using axial T2-weighted MRI. Walking ability was investigated using the 6-min walk test and daily stride counts. Maximum plantarflexion torque was quantified using isometric dynomometry. Muscle fat infiltration (MFI) and relative muscle cross-sectional area (rmCSA) were quantified using fat/water separation magnetic resonance imaging.Results: Damage ratios were negatively correlated with distance walked in 6 min, average daily strides and maximum plantarflexion torque, and a negative linear trend was found between damage ratios and lower leg rmCSA. While damage ratios were not significantly correlated with MFI, we found significantly higher MFI in the wheelchair user participant group compared to community walkers.Conclusions: Damage ratios may be useful in prognosis of motor recovery in spinal cord injury. The results warrant a large multi-site research study to investigate the value of high-resolution axial T2-weighted imaging to predict walking recovery following motor incomplete spinal cord injury.

AB - Study design: This research utilized a cross-sectional design.Objectives: Spinal cord edema length has been measured with T2-weighted sagittal MRI to predict motor recovery following spinal cord injury. The purpose of our study was to establish the correlational value of axial spinal cord edema using T2-weighted MRI. We hypothesized a direct relationship between the size of damage on axial MRI and walking ability, motor function and distal muscle changes seen in motor incomplete spinal cord injury (iSCI).Setting: University-based laboratory in Chicago, IL, USA.Methods: Fourteen participants with iSCI took part in the study. Spinal cord axial damage ratios were assessed using axial T2-weighted MRI. Walking ability was investigated using the 6-min walk test and daily stride counts. Maximum plantarflexion torque was quantified using isometric dynomometry. Muscle fat infiltration (MFI) and relative muscle cross-sectional area (rmCSA) were quantified using fat/water separation magnetic resonance imaging.Results: Damage ratios were negatively correlated with distance walked in 6 min, average daily strides and maximum plantarflexion torque, and a negative linear trend was found between damage ratios and lower leg rmCSA. While damage ratios were not significantly correlated with MFI, we found significantly higher MFI in the wheelchair user participant group compared to community walkers.Conclusions: Damage ratios may be useful in prognosis of motor recovery in spinal cord injury. The results warrant a large multi-site research study to investigate the value of high-resolution axial T2-weighted imaging to predict walking recovery following motor incomplete spinal cord injury.

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Ambulatory function in motor incomplete spinal cord injury: A magnetic resonance imaging study of spinal cord edema and lower extremity muscle morphometry

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