Cervical spinal cord proton spectroscopy and impairment in spinal cord injury at 3T

Stand-By Time

Wednesday, June 28, 2017: 12:45 PM  - 2:45 PM 

Submission No:

3578 

Submission Type:

Abstract Submission 

On Display:

Wednesday, June 28 & Thursday, June 29 

Authors:

Patrik Wyss1,2,3,4, Eveline Huber5, Patrick Freund5,6,7,8, Desiree Beck5, Armin Curt5, Spyros Kollias4, Anke Henning1,3,9

Institutions:

1Institute for Biomedical Engineering, University and ETH Zurich, Zurich, Switzerland, 2Swiss Paraplegic Centre, Nottwil, Switzerland, 3Max Planck Institute for Biological Cybernetics, Tuebingen, Germany, 4Institute of Neuroradiology, University Hospital, Zurich, Switzerland, 5Spinal Cord Injury Center, University Hospital Balgrist, University of Zurich, Zurich, Switzerland, 6Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, University College London, London, United Kingdom, 7Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, University College London, London, United Kingdom, 8Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany, 9Institute of Physics, Ernst-Moritz-Arndt University Greifswald, Greifswald, Germany

First Author:

Patrik Wyss    -  Lecture Information | Contact Me
Institute for Biomedical Engineering, University and ETH Zurich|Swiss Paraplegic Centre|Max Planck Institute for Biological Cybernetics|Institute of Neuroradiology, University Hospital
Zurich, Switzerland|Nottwil, Switzerland|Tuebingen, Germany|Zurich, Switzerland

E-Poster

Introduction:

Spinal cord injury (SCI) results, in most cases, in permanent motor and sensory deficits, both influencing quality of life. Although anatomical MRI is of clinical value to determine the level and extent of injury, as well as remote degenerative changes, its predictive value remains limited. Magnetic resonance spectroscopy (MRS) provides the means of accessing biochemical information from the neural tissue (de Graaf, 2007). Thus holding potential for a better understanding of cellular processes associated with neurodegeneration after SCI. In the present study, we examine metabolic alterations of cellular processes in the cervical spinal cord in patients with chronic SCI.

Methods:

Spectra were measured in 16 spinal cord injury patients at 3T (Achieva, Philips Healthcare, Best, The Netherlands). Fig.1 shows the demographics of the study population, the voxel localization and a sample spectrum of the cervical spinal cord. All patients underwent a comprehensive clinical protocol including 1) the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) protocol for motor, light-touch and pin-prick score (Kirshblum, 2011) and 2) the Spinal Cord Independence Measure (SCIM) to measure daily life independence. The MRS voxel (6x9x35 mm3) was placed above the level of injury at C2/3 (Fig.1 bottom) based on a T2 weighted scan (0.4x0.4x4mm3) and using the metabolite cycling technique (Hock, 2013a and Hock, 2013b). 512 signal averages were recorded [TE=30ms, TR=2000-2500ms (heart beat triggered)] and an apodization filter after 200ms was applied before quantification with LCModel (Provencher, 1993). The neurovascular SENSE coil was used to acquire the cervical spine spectra and the total scan time was 45 minutes. All statistical analyses were performed using R Version 3.3.1 (R Core Team, 2016) and the Spearman correlation was calculated between the different metabolic ratios and clinical outcome measures.
Supporting Image: figure1_20161214.png
 

Results:

N‐acetylaspartate and N-acetylaspartylglutamate (tNAA), creatine and phosphocreatine (Cr), choline-containing compounds (tCho) and myo-inositol(mI) were reliably detected in the spinal cord above the level of injury (all Cramer Rao Lower Bounds lower than 25). Significant correlations between the metabolic indices and the clinical scores are shown in Fig.2. Specifically, tNAA/mI and tCho/mI correlated with SCIM score [P=0.001 and P=0.011], and pin-prick score [P=0.032 and P=0.011] while tCho/mI correlated with light-touch score [P=0.004] and neuropathic pain intensity [P=0.021] (Fig.2 F).
Supporting Image: figure2_20161214.png
 

Conclusions:

We observed associations between the metabolic level and the clinical impairment in chronic SCI above the level of injury. Moreover, we identify an activity dependent correlation between metabolic reductions of cellular process involved in neurodegeneration and clinical impairment. Further data are being collected in additional SCI and a healthy control group will be added to access trauma-induced changes. The sensitivity of cervical spinal cord MRS holds the potential for use in therapy monitoring and may serve as a biomarker in clinical trials in SCI.

Acknowledgements:

Funding by the Swiss National Science Foundation (Grant Number: 143715) and by Wings for Life, Austria (WFL-CH-007/14) is gratefully acknowledged.

Disorders of the Nervous System:

Disorders of the Nervous System Other 2

Imaging Methods:

MR Spectroscopy 1

Poster Session:

Poster Session - Wednesday

Keywords:

Magnetic Resonance Spectroscopy (MRS)
MR SPECTROSCOPY
Spinal Cord
Other - Spinal Cord Injury

1|2Indicates the priority used for review

Would you accept an oral presentation if your abstract is selected for an oral session?

Yes

I would be willing to discuss my abstract with members of the press should my abstract be marked newsworthy:

Yes

Please indicate below if your study was a "resting state" or "task-activation” study.

Other

By submitting your proposal, you grant permission for the Organization for Human Brain Mapping (OHBM) to distribute the presentation in any format, including video, audio print and electronic text through OHBM OnDemand, social media channels or other electronic media and on the OHBM website.

I accept

Healthy subjects only or patients (note that patient studies may also involve healthy subjects):

Patients

Internal Review Board (IRB) or Animal Use and Care Committee (AUCC) Approval. Please indicate approval below. Please note: Failure to have IRB or AUCC approval, if applicable will lead to automatic rejection of abstract.

Yes, I have IRB or AUCC approval

Please indicate which methods were used in your research:

Other, Please specify  -   MR Spectroscopy, functional measures for spinal cord injury (ISNCSCI, SCIM)

For human MRI, what field strength scanner do you use?

3.0T

Which processing packages did you use for your study?

Other, Please list  -   LC Model

Provide references in author date format

de Graaf, R.A. (2007), ‘In Vivo NMR Spectroscopy: Principles and Techniques.’, 2nd Edition: John Wiley& Sons.
Hock, A. (2013a), ‘1H-MR Spectroscopy in the Human Spinal Cord’, American Journal of Neuroradiology, vol. 34, no. 9, pp. 1682-1689
Hock, A. (2013b), ’Non-water-suppressed proton MR spectroscopy improves spectral quality in the human spinal cord’, Magnetic Resonance in Medicine, vol. 69, no.5, pp. 1253-1260
Kirshblum, S.C. (2011), ‘International standards for neurological classification of spinal cord injury (Revised 2011).’ The Journal of Spinal Cord Medicine, vol. 34, no. 6, pp. 535-546
Provencher, S.W. (1993), ‘Estimation of metabolite concentrations from localized in vivo proton NMR spectra’, Magnetic Resonance in Medicine, vol. 30, no. 6, pp. 672-679
R Core Team (2016), ‘R: A language and environment for statistical computing. R Foundation for Statistical Computing’, Vienna, Austria. URL https://www.R-project.org/
Provencher, S.W. (1993), ‘Estimation of metabolite concentrations from localized in vivo proton NMR spectra’, Magnetic Resonance in Medicine, vol. 30, no. 6, pp. 672-679
R Core Team (2016), ‘R: A language and environment for statistical computing. R Foundation for Statistical Computing’, Vienna, Austria. URL https://www.R-project.org/