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  4. Width and neurophysiologic properties of tissue bridges predict recovery after cervical injury

Width and neurophysiologic properties of tissue bridges predict recovery after cervical injury

Neurology, 2019 · DOI: 10.1212/WNL.0000000000007642 · Published: June 11, 2019

Spinal Cord InjuryNeuroimagingPhysiology

Simple Explanation

This study investigates the relationship between preserved tissue in the spinal cord after injury and a patient's recovery. Specifically, it looks at 'midsagittal tissue bridges,' which are areas of remaining neuronal tissue. The study uses MRI scans to measure the width of these tissue bridges and electrophysiological recordings to assess nerve function. The goal is to determine if these measurements can predict sensory and motor recovery after a cervical spinal cord injury (SCI). The findings suggest that wider tissue bridges, particularly in specific areas (dorsal and ventral), are associated with better sensory and motor function recovery. This indicates that these tissue bridges play a crucial role in nerve communication and recovery after SCI.

Study Duration
12 months
Participants
28 tetraplegic patients
Evidence Level
Longitudinal retrospective study

Key Findings

  • 1
    Greater width of dorsal midsagittal tissue bridges was associated with being sensory incomplete at 12 months, shorter SEP latencies, and greater SEP amplitudes.
  • 2
    Greater width of dorsal tissue bridges predicted better light-touch score at 12 months, independent of baseline clinical score and ventral tissue bridges.
  • 3
    Greater width of ventral midsagittal tissue bridges was associated with being motor incomplete at 12 months, shorter MEP latencies, and greater MEP amplitude to CMAP amplitude ratios.

Research Summary

This study assessed the predictive value of midsagittal tissue bridges on MRI for sensorimotor recovery after cervical SCI. The width of dorsal tissue bridges correlated with sensory recovery and SEP measures, while the width of ventral tissue bridges correlated with motor recovery and MEP measures. The findings suggest that these tissue bridges can serve as sensory- and motor-specific predictors of recovery and could be integrated into diagnostic workups and clinical trials.

Practical Implications

Improved Prognosis

Midsagittal tissue bridge measurements can provide early and specific information about potential sensorimotor recovery after SCI.

Targeted Therapies

Understanding the role of dorsal and ventral tissue bridges can help develop targeted therapies to promote specific sensory or motor recovery.

Clinical Trial Stratification

Neuroimaging biomarkers of midsagittal tissue bridges can be integrated into patient stratification in clinical trials to better assess treatment efficacy.

Study Limitations

  • 1
    Retrospective case-series study may have selection bias.
  • 2
    Tissue bridges could not be assessed on T2-weighted axial slices because of their low spatial resolution.
  • 3
    Not all patients had MEP and SEP potentials, thus reducing the number of observations in some regression analyses.

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