An international team, including BRC-supported researchers, has found evidence that patients already have irreversible tissue loss within 40 days of a spinal cord injury.
Researchers from the National Institute for Health Research (NIHR) University College London Hospitals Biomedical Research Centre, the University of Zurich and University Hospital Balgrist used a new imaging measurement technique, developed at the Wellcome Trust Centre for Neuroimaging in Queen Square, to determine the impact of therapeutic treatments and rehabilitative interventions quickly and directly.
A spinal cord injury changes the functional state and structure of the spinal cord and the brain. For example, a patient’s ability to walk or move their hands can become restricted. How quickly such degenerative changes develop, however, has remained a mystery until now. The assumption was that it took years for patients with a spinal cord injury to also display anatomical changes in the spinal cord and brain above the injury site. This study, published in the journal Lancet Neurology, demonstrates for the first time that these changes already occur within 40 days of acute spinal cord injury.
Researchers assessed 13 patients with acute spinal cord injuries every three months for a year using state-of-the-art MRI (magnetic resonance imaging). They discovered that the diameter of the spinal cord had rapidly decreased and was already seven per cent smaller after 12 months.
A lesser volume decline was also evident in the corticospinal tract, which is essential for motor control, and nerve cells in the sensorimotor cortex, an area of the cortex which combines sensory and motor functions. Patients with a greater tissue loss above the injury site recovered less effectively than those with fewer changes.
BRC-supported Professor Alan Thompson, an NIHR senior investigator and Dean of UCL Brain Sciences, said: “If there is damage to nerve fibres in one location, that damage will travel along the nerve fibre and hit cells that feed the nerve fibre, limiting the potential for recovery”.
Summarising the findings, Professor Thompson added: “We found that the maximum change in imaging biomarkers - shown locally and remotely - occurs almost immediately after a traumatic event, so early intervention around repair is critical”.
Treatments targeting the injured spinal cord have now entered clinical trials and gaining insight into mechanisms of repair and recovery within the first year are crucial. Thanks to the use of the new neuroimaging protocols there is now possibility of displaying the effect of therapeutic treatments on the central nervous system and of rehabilitative measures more quickly. Consequently, the effect of new therapies can also be recorded more rapidly.
The findings are the result of a new three-year neuroscience partnership between UCL and the Neuroscience Centre Zurich (ZNZ), representing both the University of Zurich and the Swiss Federal Institute of Technology (ETHZ).
