Objective To investigate whether gray matter pathology above the level of injury, alongside white matter changes, also contributes to sensorimotor impairments after spinal cord injury. Methods A 3T MRI protocol was acquired in 17 tetraplegic patients and 21 controls. A sagittal T2-weighted sequence was used to characterize lesion severity. At the C2-3 level, a high-resolution T2*-weighted sequence was used to assess cross-sectional areas of gray and white matter, including their subcompartments; a diffusion-weighted sequence was used to compute voxel-based diffusion indices. Regression models determined associations between lesion se-verity and tissue-specific neurodegeneration and associations between the latter with neuro-physiologic and clinical outcome. Results Neurodegeneration was evident within the dorsal and ventral horns and white matter above the level of injury. Tract-specific neurodegeneration was associated with prolonged con-duction of appropriate electrophysiologic recordings. Dorsal horn atrophy was associated with sensory outcome, while ventral horn atrophy was associated with motor outcome. White matter integrity of dorsal columns and corticospinal tracts was associated with daily-life independence.
Huber, E., David, G., Thompson, A. J., Weiskopf, N., Mohammadi, S., & Freund, P. (2018). Dorsal and ventral horn atrophy is associated with clinical outcome after spinal cord injury. Neurology, 10.1212/WNL.0000000000005361. https://doi.org/10.1212/wnl.0000000000005361