Abstract
BackgroundTraumatic spinal cord injury (SCI) results in sensory and motor function impairment and may cause a substantial social and economic burden. For the implementation of novel treatment strategies, parallel development of objective tools evaluating spinal cord (SC) integrity during motor function recovery (MFR) is needed. Diffusion tensor imaging (DTI) enables in vivo microstructural assessment of SCI.MethodsIn the current study, temporal evolvement of DTI metrics during MFR were examined; therefore, values of fractional anisotropy (FA) and apparent diffusion coefficient (ADC) were measured in a population of 17 paraplegic dogs with naturally-occurring acute SCI showing MFR within 4 weeks after surgical decompression and compared to 6 control dogs. MRI scans were performed preoperatively and 12 weeks after MFR was observed. DTI metrics were obtained at the lesion epicentre and one SC segment cranially and caudally. Variance analyses were performed to compare values between evaluated localizations in affected dogs and controls and between time points. Correlations between DTI metrics and clinical scores at follow-up examinations were assessed.ResultsBefore surgery, FA values at epicentres were higher than caudally (p = 0.0014) and control values (p = 0.0097); ADC values were lower in the epicentre compared to control values (p = 0.0035) and perilesional (p = 0.0448 cranially and p = 0.0433 caudally). In follow-up examinations, no significant differences could be found between DTI values from dogs showing MFR and control dogs. Lower ADC values at epicentres correlated with neurological deficits at follow-up examinations (r = − 0.705; p = 0.0023).ConclusionsFindings suggest that a tendency to the return of DTI values to the physiological situation after surgical decompression accompanies MFR after SCI in paraplegic dogs. DTI may represent a useful and objective clinical tool for follow-up studies examining in vivo SC recovery in treatment studies.
Highlights
Traumatic spinal cord injury (SCI) results in sensory and motor function impairment and may cause a substantial social and economic burden
The aim of this study is to describe the temporal evolvement of Diffusion ten‐ sor imaging (DTI) metrics in paraplegic dogs with acute SCI showing motor function recovery (MFR) after surgical decompression of the spinal cord
SCI dogs Private owned dogs admitted to the Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover were prospectively recruited in a period between June 2013 and April 2015 with the following inclusion criteria: acute (≤ 6 days) onset of paraplegia consistent with T3-L3 SCI after intervertebral disc herniation (IVDH) with either presence or absence of deep pain perception (DPP), a body weight less than 20 kg and recovery of voluntary motor function within 4 weeks after decompressive surgery (Fig. 1)
Summary
Traumatic spinal cord injury (SCI) results in sensory and motor function impairment and may cause a substantial social and economic burden. Spinal cord injury (SCI), a devastating disease affecting the central nervous system, has a worldwide estimated incidence range in humans from 3.6 to 195.4 cases per million [1]. It involves individual damage of motor and visceral functions and leads to detriments in quality of life and represents a high economic burden [2]. Curative therapies for SCI are currently subject of research and development of techniques that may enable an objective assessment of recovery phases are needed [3,4,5,6]. The dog is increasingly recognized as a large animal translational model for various pathologies of the central nervous system including multiple sclerosis, epilepsy and traumatic SCI [9, 11,12,13,14,15,16,17]
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