Brain cortex structural changes in complete spinal cord injury detected by MRI

English Keywords:Spinal cord injury  MRI  Sensorimotor system  Structural changes

English Abstract:

  【Abstract】 Objectives: To investigate the brain structural changes during the early stage of complete spinal cord injury(SCI) and the relationships between these structural changes and the injury extent of patients′ sensorimotor functions. Methods: From October to December 2013, 13 patients with complete SCI were included from the department of orthopedics of General Hospital of Beijing Military Region, including 7 males and 6 females with the age ranging from 21 to 40 years(average, 26.3±7.9 years). Meanwhile, 15 healthy controls were enrolled, including 8 males and 7 females with the age ranging from 20 to 38 years(average, 25.7±5.8 years). The mean injury time of SCI patients was 64.4±20.3 days(ranged 28-84 days). The neurologic assessment was performed using the American Spinal Injury Association(ASIA) Standard Neurologic Classification of SCI. The ASIA impairment scale(AIS) and ASIA motor score were assessed. In this study, all patients have the grade of A of ASIA impairment scale, and have the total ASIA motor score 36.5±25.9(range, 18-55), ASIA pinprick sensory score 43.3±27.3 (range, 27-88), ASIA light touch sensory score 42.5±30.3(range, 25-80). All of the patients performed the MRI scan on the day of arrival. Voxel-based morphometry was used to investigate the regions with gray matter volume changes. Pearson correlation analysis was used to explore the relationship between the brain structural changes and patients′ sensorimotor function. Results: Compared with healthy controls, complete SCI patients showed significant decreased gray matter volume in the primary motor cortex, primary somatosensory cortex and supplementary motor area(P>0.05). In addition, there was no significant correlations between the extents of atrophy in these regions and the American Spinal Injury Association motor or sensory score in patients with SCI(P>0.05). Conclusions: At the early stage of injury, the complete SCI patients showed significant gray matter atrophy in the primary motor cortex, primary somatosensory cortex and supplementary motor area, however, the extents of atrophy in these regions were not related to the injujry extents of patients′ sensorimotor functions.