| 제목 |
Correlation between Fiber Tractography and Clinical Status in Patients with Spinal Cord Injury |
| 소속 |
Dankook University Hospital, Department of Rehabilitation Medicine1, Dankook University, Department of Nanobiomedical Science & WCU Research Center2, Dankook University, Institute of Tissue Regeneration Engineering (ITREN)3 |
| 저자 |
Kyung Cheon Seo1*, Seong Jae Lee 1, Jung Keun Hyun1,2, Tae Uk Kim1, Seo Young Kim1† |
Objective: To delineate the usefulness of diffusion tensor imaging (DTI) and tractography by analyzing correlation with the neurological and functional status in patients with spinal cord injury (SCI)
Method: We recruited 34 patients with spinal cord injury who performed diffusion tensor tractography initially. Imaginary fiber numbers at each cervical level from C3 to C7 level and crossing fiber numbers from C3 to C5, C6, or C7 were calculated. Neurological status including the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and functional status including Functional Independence Measurement (FIM), and Korean modified Barthel index (K-MBI) were reviewed at admission and after 4 weeks. We assessed the statistical correlation between fiber numbers and neurological and functional scores. Eight patients who performed follow-up diffusion tensor tractography after cervical spine operation were also evaluated the statistical correlation between the changes of fiber numbers and that of neurological and function recovery.
Results: The K-MBI score (p = 0.038) and self-care score of FIM (p = 0.046) were significantly associated with the crossing fiber numbers from C3 to C6 at admission. Also, the K-MBI score (p = 0.044), transfer/locomotion of FIM (p = 0.014) and total FIM score (p = 0.046) were also significantly associated with the crossing fiber numbers from C3 to C7 at admission.
The changes of light touch sense score of upper extremities (p = 0.029) was significantly associated with the imaginary fiber numbers at C4 level. The change of motor score of Lt. upper extremity was significantly associated with the imaginary fiber numbers at the C7 level. (p = 0.024).
All follow-up imaginary fiber numbers and crossing fiber numbers were less than those at admission. However, there were strongly positive correlations between the changes of the imaginary fiber numbers and the gain of transfer/locomotion score of FIM (p = 0.042, r = 0.829) and the changes of the crossing fiber numbers from C3 to C5 and gain of self-care score of FIM (p = 0.036, r = 0.841).
Conclusion: The imaginary fiber numbers at each cervical level and fiber numbers crossing the cervical lesion are associated with the neurological and functional status. Although follow-up DTI did not well reflect the neurologic and functional status because of the surgery, the changes in DTI data might help predict the prognosis of functional status.
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