ArticleAnnals of clinical and translational neurology2025
3D MRI Tract-Specific Spinal Cord Lesion Pattern Improves Prediction of Distinct Neurological Recovery.
Article in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo distinguish lateralized motor- and sensory-tract damage after acute spinal cord injury (SCI) and explore its predictive power for motor and sensory recovery.
methodsThirty-five SCI patients (two female) from a multi-center data set (placebo-arm of the Nogo-A-Inhibition in SCI trial) underwent routine T2-weighted sagittal MRI scans at the lesion site at baseline (19.9 days, 95% confidence interval [CI]: 17.9-21.8), 1-month (54.2 days, 95% CI: 52.1-56.2), and 6-month (192.4 days, 95% CI: 181.3-203.6) post-injury. Concurrently with the MRI scans, clinical examinations were performed. Lesions were manually segmented across all slices, and 3D-tract damage was assessed by determining the overlap between segmented lesions and identified motor and sensory tracts in the axial plane. The relationship between lesion assessments and baseline-adjusted clinical outcomes at 6 months was explored.
resultsOver the 6-month, patients recovered by 4.95 motor points/month (95% CI: 3.89-5.89, p < 0.001) on the International Standards for the Neurological Classification of SCI scale, 2.28 light-touch points/month (95% CI: 1.43-3.12, p < 0.001), and 2.06 pinprick points/month (95% CI: 1.21-2.91, p < 0.001). Lesion volume decreased from 381.82mm
interpretationRevealing the extent of damage to spinal motor-and sensory-pathways early after SCI is a valuable predictor of related neurological recovery. Tracking 3D dynamics of major spinal pathways has the potential to enhance diagnostic accuracy and patient stratification for future clinical trials.
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