Spinal and Cerebral biomarkers for measuring disease progression and prognosis in chronic spinal cord injury

用于测量慢性脊髓损伤疾病进展和预后的脊髓和大脑生物标志物

基本信息

批准号：
10368062
负责人：
Benjamin M. Ellingson
金额：
$ 38.81万
依托单位：
UNIVERSITY OF CALIFORNIA LOS ANGELES
依托单位国家：
美国
项目类别：
财政年份：
2012
资助国家：
美国
起止时间：
2012-09-26 至 2025-02-28
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10368062
关键词：
Adult Age-Years Anatomy Anisotropy Area Atrophic Biochemistry Biological Assay Biological Markers Brain Cell physiology Cerebrum Cervical Cervical spinal cord structure Cervical spine Chronic Clinical Complex Corticospinal Tracts Diffuse Diffusion Magnetic Resonance Imaging Disease Disease Progression Functional Magnetic Resonance Imaging Functional disorder Funding Goals Imaging Techniques Impairment Individual Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Measurement Measures Metabolic Metabolism Monitor Motor Multimodal Imaging Neck Pain Nervous System Physiology Neuraxis Neurologic Neuronal Plasticity Operative Surgical Procedures Pain Pathogenesis Patients Process Prognosis Recovery Research Rest Role Running Societies Spinal Spinal Cord Spinal Cord Diseases Spinal cord injury Spondylosis Structure Techniques Thick Treatment Cost Vertebral column Work base cerebral atrophy disease prognosis intervertebral disk degeneration knowledge base neuroimaging neurological recovery normal aging postoperative recovery preservation relating to nervous system response spectroscopic imaging spinal cord imaging surgery outcome

项目摘要

Project Summary/Abstract Degenerative disc disease, a term frequently referred to as spondylosis, occurs as part of the normal aging process and its treatment costs run in the many billions of dollars per year. Cervical spondylotic myelopathy (CSM), a form of chronic spinal cord injury (SCI), is the most debilitating type of degenerative disc disease, and is the most common acquired cause of spinal cord dysfunction in adults greater than 50 years of age. In many ways, its impact on society is greater than traumatic SCI due to the substantially larger number of patients afflicted with this disorder. There are several critical gaps in our understanding of CSM pathogenesis and treatment, in part due to the fact that the vast majority of CSM research has investigated the spinal cord in isolation, and not assayed other supraspinal structures within the CNS that are anatomically and functionally interrelated. Moreover, many of these isolated cervical spine studies have utilized standard MRI, which provides excellent macroscopic detail, but little information regarding the spinal cord microstructure, cellular physiology, or metabolism. Recent studies have demonstrated the role of cerebral reorganization and neural plasticity as compensatory mechanisms to preserve neurological function following traumatic SCI. We have previously elucidated similar findings in CSM patients utilizing both task based and resting functional MRI. During our previous funding period, we established Diffusion Tensor Imaging and MR spectroscopy as suitable techniques for assessing the spinal cord microstructure and biochemistry, and demonstrated correlations with these biomarkers to degree of neurological impairment. We now propose to build upon our previous work by developing a multi-modality imaging paradigm that probes the impact of supraspinal plasticity on CSM pathogenesis and recovery in tandem with advanced spinal cord imaging techniques MRS and DTI to yield a complete view of the entire sensorimotor network. In addition to greatly enhancing our knowledge base regarding chronic SCI pathogenesis and recovery, we seek to utilize these advanced imaging techniques to bridge current clinical gaps in the monitoring of CSM patients managed nonoperatively, as well as prediction of surgical outcome in those treated with surgery.

项目概要/摘要退行性椎间盘疾病，通常称为脊椎病，是椎间盘退行性病变的一部分。正常的衰老过程及其治疗费用每年高达数十亿美元。宫颈脊髓病 (CSM) 是慢性脊髓损伤 (SCI) 的一种形式，是最令人衰弱的疾病退行性椎间盘疾病的类型，是脊髓最常见的后天病因 50岁以上成年人的功能障碍。从很多方面来说，它对社会的影响更大与外伤性 SCI 相比，由于患有这种疾病的患者数量要多得多。我们对 CSM 发病机制和治疗的理解存在几个关键差距，部分是由于绝大多数 CSM 研究都是孤立地研究脊髓，并没有分析中枢神经系统内的其他脊柱上结构，这些结构在解剖学上和功能上相互关联。此外，许多孤立的颈椎研究都利用了标准 MRI，可提供出色的宏观细节，但有关脊髓微观结构、细胞生理学或新陈代谢。最近的研究证明了大脑重组和神经可塑性的作用创伤性 SCI 后保护神经功能的补偿机制。我们有先前在 CSM 患者中利用基于任务和休息的方法阐明了类似的发现功能性磁共振成像。在我们之前的资助期间，我们建立了扩散张量成像和磁共振波谱作为评估脊髓微观结构的合适技术生物化学，并证明了这些生物标志物与神经系统程度的相关性损害。我们现在建议在我们之前的工作基础上开发一种多模式探讨脊髓上可塑性对 CSM 发病机制影响的成像范式结合先进的脊髓成像技术 MRS 和 DTI 进行恢复，以产生整个感觉运动网络的完整视图。除了大大提升我们的知识面基于慢性 SCI 发病机制和恢复的基础，我们寻求利用这些先进的成像技术弥合当前 CSM 患者监测方面的临床差距非手术治疗，以及手术治疗患者手术结果的预测。

项目成果

期刊论文数量（33）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Spinal Cord Signal Intensity Predicts Functional Outcomes in the Operative Management of Degenerative Cervical Myelopathy.

脊髓信号强度可预测退行性脊髓型颈椎病手术治疗中的功能结果。

DOI：
10.1097/bsd.0000000000001479
发表时间：
2023
期刊：
Clinical spine surgery
影响因子：
1.9
作者：
Firempong,GaylinnKwame;Sheppard,WilliamL;Gelfand,Yaroslav;Ellingson,BenjaminM;Holly,LangstonT
通讯作者：
Holly,LangstonT

Compensatory brainstem functional and structural connectivity in patients with degenerative cervical myelopathy by probabilistic tractography and functional MRI.