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. 2019 Feb 12:13:11.
doi: 10.3389/fnhum.2019.00011. eCollection 2019.

White Matter Microstructure Alterations in Patients With Spinal Cord Injury Assessed by Diffusion Tensor Imaging

Yun Guo  1   2   3   4   5 , Feng Gao  1   2   3   4   5 , Yaou Liu  6 , Hua Guo  7 , Weiyong Yu  8 , Zhenbo Chen  8 , Mingliang Yang  1   2   3   4   5 , Liangjie Du  1   2   3   4   5 , Degang Yang  1   2   3   4   5 , Jianjun Li  1   2   3   4   5
Affiliations

White Matter Microstructure Alterations in Patients With Spinal Cord Injury Assessed by Diffusion Tensor Imaging

Yun Guo et al. Front Hum Neurosci. .

Abstract

Compared to healthy controls, spinal cord injury (SCI) patients demonstrate white matter (WM) abnormalities in the brain. However, little progress has been made in comparing cerebral WM differences between SCI-subgroups. The purpose of this study was to investigate WM microstructure differences between paraplegia and quadriplegia using tract-based spatial statistics (TBSS) and atlas-based analysis methods. Twenty-two SCI patients (11 cervical SCI and 11 thoracic SCI) and 22 age- and sex-matched healthy controls were included in this study. TBSS and atlas-based analyses were performed between SCI and control groups and between SCI-subgroups using multiple diffusion metrics, including fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD). Compared to controls, SCI patients had decreased FA and increased MD and RD in the corpus callosum (CC; genu and splenium), superior longitudinal fasciculus (SLF), corona radiata (CR), posterior thalamic radiation (PTR), right cingulum (cingulate gyrus; CCG) and right superior fronto-occipital fasciculus (SFOF). Cervical SCI patients had lower FA and higher RD in the left PTR than thoracic SCI patients. Time since injury had a negative correlation with FA within the right SFOF (r = -0.452, p = 0.046) and a positive association between the FA of left PTR and the American Spinal Injury Association (ASIA) sensory score (r = 0.428, p = 0.047). In conclusion, our study suggests that multiple cerebral WM tracts are damaged in SCI patients, and WM disruption in cervical SCI is worse than thoracic injury level, especially in the PTR region.

Keywords: atlas-based analysis; cerebral white matter microstructure; diffusion tensor imaging; spinal cord injury; tract-based spatial statistics.

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Figures

Figure 1
Figure 1
WM tract regions of interest (ROIs) based on the ICBM-DTI-81 WM labels atlas in cerebral regions. Abbreviations for WM tracts can be seen in Supplementary Table S1.
Figure 2
Figure 2
Tract-based spatial statistics (TBSS) results of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) images between the spinal cord injury (SCI) group and control (Cont) group. The background is based on MNI152_T1_1 mm. Green represents the mean white matter (WM) skeleton of all subjects; red color, pink and blue (the skeletonized results are “thickened” for easier visualization) represent regions with decreased FA, increased MD and increased RD in SCI patients respectively [p < 0.05, family-wise error (FWE) corrected for multiple comparisons].
Figure 3
Figure 3
Mean diffusion metrics of the atlas-based tracts in SCI and healthy control groups. All the WM tracts shown were significantly different after FDR correction. Abbreviations of WM tracts can be seen in Supplementary Table S1.
Figure 4
Figure 4
Significant correlations between months since injury and FA values in the right superior frontooccipital fasciculus (SFOF) in patients with SCI.
Figure 5
Figure 5
TBSS results of FA and RD images between cervical SCI (CSCI) and thoracic SCI (TSCI) groups. The background is based on MNI152_T1_1 mm. Green represents the mean WM skeleton of all SCI patients; red-yellow (the skeletonized results are “thickened” for easier visualization) represents regions with decreased FA and increased RD in CSCI patients (p < 0.05, FWE corrected for multiple comparisons).
Figure 6
Figure 6
Mean FA values of bilateral posterior thalamic radiations (PTRs) in CSCI and TSCI. CSCI, cervical spinal cord injury; TSCI, thoracic spinal cord injury; *P < 0.05.
Figure 7
Figure 7
Significant correlations between total sensory score and FA values in the left PTRs in SCI patients.
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