Pathological and Biomedical Characteristics of Spinal Cord Injury Determined Using Diffusion Tensor Imaging

Traumatic spinal cord injury: SCI) is the most devastating injury that often causes the victim permanent paralysis and undergo a lifetime of therapy and care. It is caused by a mechanical impact that ultimately causes pathophysiological consequences which at this moment in time are an unresolved scientific challenge of great social impact. Scientists have long used animal contusion models to study the pathophysiology of SCI in the discovery of progressive secondary tissue degeneration, demyelination, and apoptosis. More importantly, most therapies that have gone to human clinical trial were first validated in spinal cord contusion models. Magnetic resonance imaging: MRI) is the modality of choice to noninvasively detect the soft tissue injury, particularly suitable for assessing the tissue integrity in SCI. However, the convention MRI lacks capability of detecting and evaluating the injury severity acutely, probably resulting in lost opportunities of effective prognostication or treatment stratification for SCI patients. Diffusion Tensor Magnetic Resonance Imaging: DTMRI, DTI) is an emerging technique known to provide dynamic contrast reflecting the progression of the underlying pathology in CNS tissues. In this study, we hypothesized that axial: ||) and radial: λ^) diffusivity derived from DTI is sensitive to the pathological alteration in spinal cord white matter: WM) tract and could be used as potential biomarkers detecting and characterizing the axonal and myelin damage in SCI. A mouse model of contusion SCI was examined using DTI, behavioral assessment, and histology to test our hypothesis. Techniques employed including the simplification of diffusion weighting scheme, the implementation of diffusion weighted multiple spin-echo sequence, and verified for setting up the experimental protocol and data processing procedures. Secondly, the hypothesis was test on the projects comparing the change of these biomarkers on both the myelinated and dysmyelinated shiverer mice cooperating with histological analysis, and behavioral assessment. Finally, a finite element analysis: FEA) of contusion SCI was deployed to provide evidences of injury mechanics correlated with the injury patterns detected by diffusion MRI for a better characterized animal model of contusion SCI

Neuroprotection and neuroregeneration: roles for the white matter

Efficient strategies for neuroprotection and repair are still an unmet medical need for neurodegenerative diseases and lesions of the central nervous system. Over the last few decades, a great deal of attention has been focused on white matter as a potential therapeutic target, mainly due to the discovery of the oligodendrocyte precursor cells in the adult central nervous system, a cell type able to fully repair myelin damage, and to the development of advanced imaging techniques to visualize and measure white matter lesions. The combination of these two events has greatly increased the body of research into white matter alterations in central nervous system lesions and neurodegenerative diseases and has identified the oligodendrocyte precursor cell as a putative target for white matter lesion repair, thus indirectly contributing to neuroprotection. This review aims to discuss the potential of white matter as a therapeutic target for neuroprotection in lesions and diseases of the central nervous system. Pivot conditions are discussed, specifically multiple sclerosis as a white matter disease; spinal cord injury, the acute lesion of a central nervous system component where white matter prevails over the gray matter, and Alzheimer's disease, where the white matter was considered an ancillary component until recently. We first describe oligodendrocyte precursor cell biology and developmental myelination, and its regulation by thyroid hormones, then briefly describe white matter imaging techniques, which are providing information on white matter involvement in central nervous system lesions and degenerative diseases. Finally, we discuss pathological mechanisms which interfere with myelin repair in adulthood

CXCR7 antagonism prevents axonal injury during experimental autoimmune encephalomyelitis as revealed by in vivo axial diffusivity

<p>Abstract</p> <p>Background</p> <p>Multiple Sclerosis (MS) is characterized by the pathological trafficking of leukocytes into the central nervous system (CNS). Using the murine MS model, experimental autoimmune encephalomyelitis (EAE), we previously demonstrated that antagonism of the chemokine receptor CXCR7 blocks endothelial cell sequestration of CXCL12, thereby enhancing the abluminal localization of CXCR4-expressing leukocytes. CXCR7 antagonism led to decreased parenchymal entry of leukocytes and amelioration of ongoing disease during EAE. Of note, animals that received high doses of CXCR7 antagonist recovered to baseline function, as assessed by standard clinical scoring. Because functional recovery reflects axonal integrity, we utilized diffusion tensor imaging (DTI) to evaluate axonal injury in CXCR7 antagonist- versus vehicle-treated mice after recovery from EAE.</p> <p>Methods</p> <p>C57BL6/J mice underwent adoptive transfer of MOG-reactive Th1 cells and were treated daily with either CXCR7 antagonist or vehicle for 28 days; and then evaluated by DTI to assess for axonal injury. After imaging, spinal cords underwent histological analysis of myelin and oligodendrocytes via staining with luxol fast blue (LFB), and immunofluorescence for myelin basic protein (MBP) and glutathione S-transferase-π (GST-π). Detection of non-phosphorylated neurofilament H (NH-F) was also performed to detect injured axons. Statistical analysis for EAE scores, DTI parameters and non-phosphorylated NH-F immunofluorescence were done by ANOVA followed by Bonferroni post-hoc test. For all statistical analysis a p < 0.05 was considered significant.</p> <p>Results</p> <p><it>In vivo </it>DTI maps of spinal cord ventrolateral white matter (VLWM) axial diffusivities of naïve and CXCR7 antagonist-treated mice were indistinguishable, while vehicle-treated animals exhibited decreased axial diffusivities. Quantitative differences in injured axons, as assessed via detection of non-phosphorylated NH-F, were consistent with axial diffusivity measurements. Overall, qualitative myelin content and presence of oligodendrocytes were similar in all treatment groups, as expected by their radial diffusivity values. <b/>Quantitative assessment of persistent inflammatory infiltrates revealed significant decreases within the parenchyma of CXCR7 antagonist-treated mice versus controls.</p> <p>Conclusions</p> <p>These data suggest that CXCR7 antagonism not only prevents persistent inflammation but also preserves axonal integrity. Thus, targeting CXCR7 modifies both disease severity and recovery during EAE, suggesting a role for this molecule in both phases of disease.</p

Traumatic spinal cord injury; Theranostic applications of advanced MRI techniques

Imaging technology is an important part of the diagnosis and management of spinal trauma. However, many efforts have been made to develop new diagnostic biomarkers through advanced imaging techniques. Unfortunately, there is still no consensus for practical use of biomarkers in SCI patients. The authors conducted an all-encompassing literature review and relevant images were included as examples. Spinal cord and soft-tissue injuries are best evaluated by magnetic resonance imaging (MRI). However, advanced MRI techniques provide researchers with a noninvasive approach that allows evaluation of physiological and biochemical condition of the spinal cord and the brain at cellular and molecular level. The advent of new rehabilitation and treatment strategies could demand more precise and advanced techniques to approach the pathophysiology and anatomy of the spinal cord, offering more accurate and non-invasive support to research and clinical follow up

Correlation of Diffusion Tensor Imaging Indices with Histological Parameters in Rat Cervical Spinal Cord Gray Matter Following Distal Contusion Spinal Cord Injury

The purpose of this study was to delineate the diffusion tensor imaging (DTI) parameters across the cervical spinal cord gray matter (GM) in a distal (T8) rat contusion spinal cord injury (SCI) model. DTI data were obtained from ex vivo rat spinal cords and registered to corresponding histological slices in samples from the acute through chronic stages of SCI including uninjured control, 2 weeks post injury, 15 weeks post injury and 25 weeks post injury groups (n = 5 in all groups). After imaging, samples were dehydrated, blocked in paraffin, sliced axially and stained with eriochrome cyanine R stain and H&E counter-stain. A corresponding sample was post fixed with osmium tetroxide and stained with toluidine blue. Histology images of the eriochrome cyanine R stained and H&E counter-stained slices were captured at 4x and then segmented into white matter (WM) and GM and dorsal and ventral GM using a custom cluster analysis. Using whole cord templates, DTI images for each animal were then registered to the corresponding histology images. The WM and the GM regions of interest (ROI) histological templates were then used to map DTI indices, including fractional anisotropy (FA), longitudinal apparent diffusion coefficient (lADC) and transverse apparent diffusion coefficient (tADC) across the GM. The average values for each index were also calculated in predefined gray matter ROIs. Histology images of the above mentioned ROIs were captured at 40x resolution using the toluidine blue stained slices for the control and post injury groups (n=4). Motoneuron size in the ventral GM was calculated for each of the control and post injury groups. It was observed that the FA and lADC values in the dorsal GM ROI were significantly higher than that in the ventral GM ROI in controls, fifteen weeks post injury and twenty five weeks post injury groups (P \u3c 0.05). The overall GM FA value at twenty five weeks was significantly higher than the FA value at two weeks post injury (P \u3c 0.05) and the FA value in controls (P \u3c 0.05). Group analysis of the size of the motor neurons showed a 9% increase in the motoneuron size at two weeks (P \u3c 0.01) and 42% increase at twenty five weeks (P \u3c 0.01) post injury as compared to controls. The motor neurons also showed a significant increase in size at twenty five weeks post injury (P \u3c 0.01) as compared to the motor neuron size at two weeks post injury. These results indicate changes in gray matter structure rostral to a contusion injury that can be detected and monitored using DTI

Neuroimaging and Extracellular Matrix Based Approaches to Optic Neuropathy

There are approximately 2.4 million acute ocular injuries annually in the U.S. Twenty percent of these injuries result in partial or complete blindness due to traumatic injury to retinal ganglion cells (RGC). Like all central nervous system (CNS) neurons, RGC fail to regenerate injured axons because of multiple factors that lead to secondary tissue damage. We currently lack a therapeutic platform that can alter the default non-regenerative healing response. Stated differently, we lack a method to preserve or restore CNS function. Extracellular matrix (ECM) bioscaffolds have been shown to promote site appropriate tissue remodeling in multiple anatomical sites through stem and progenitor cell recruitment, proliferation, and differentiation. Additionally, redirection of the default immune response is facilitated by providing factors derived from the ECM that promote the phenotypic transition of immune cells from a pro-inflammatory to a pro-remodeling state. Recently discovered matrix bound nanovesicles (MBV) were found in all tested laboratory produced and commercially available ECM. MBV are bioactive and recapitulate some effects of the parent ECM from which they are derived and represent a potentially significant vertical advance in treating traumatic optic nerve and retinal injuries. The objective of the present thesis was to determine the efficacy of ECM and MBV to repair optic nerve and retinal tissue. First, we determined the functional and spatiotemporal changes in the visual system after acute ocular injury. Next, we measured the effect of ECM on optic nerve remodeling and the inflammatory response. Finally, we characterized the effect of MBV on the inflammatory response, RGC survival, and retinal function after acute ocular injury. ECM improved tissue remodeling in some animals. However, the results were variable, indicating ECM has the potential to improve CNS remodeling, but may not be the optimal treatment platform in the visual system. MBV increased RGC neurite outgrowth and suppressed pro-inflammatory microglia and astrocyte polarization in vitro, and increased RGC survival and retinal function after ocular injury. MBV offer an easily injectable, minimally invasive therapy that can improve RGC survival and potentially increase visual function after ocular injury

Assessing Optic Neuritis in a Mouse Model of Multiple Sclerosis with Diffusion MR Imaging

Optic neuritis (ON) is an early manifestation in patients of multiple sclerosis (MS), typically resulting in visual dysfunction. The inflammatory demyelination of the optic nerve in ON closely resembles pathologies of the rest of central nervous system (CNS) white matter in MS. Since accumulated axonal degeneration in MS was considered as the potential cause leading to permanent disability, correlating optic nerve pathology and visual function in ON could be a model system to investigate the relationship between functional outcome and neuropathology. It may also present a new way to reflect the disease progression in MS. Various MR techniques have been used to assess inflammation (inflammatory cell infiltration and vasogenic edema) of ON, but rarely demonstrated the ability to image cellularity changes non-invasively. Diffusion MRI measures the Brownian motion of water molecules in the microstructure of biological tissues. Diffusion tensor imaging (DTI) holds the promise to provide a specific biomarker of axonal injury and demyelination in CNS white matter by axial diffusivity (the diffusion parallel to white matter fibers) and radial diffusivity (the diffusion perpendicular to white matter fibers), respectively. However, DTI assumes a single diffusion tensor model and thus takes an average of varied diffusion components. In contrast, our recently developed diffusion basis spectrum imaging (DBSI) resolves the complex diffusion components and provides relatively accurate directional diffusivities and diffusion component fractions, relating to the detail and accurate pathological picture of the disease or injury. In the current work, in vivo 25-direction DBSI was applied to the optic nerve of mice with experimental autoimmune encephalomyelitis (EAE), an animal model of MS, with visual impairment at onset of ON. Our results demonstrate that inflammation correlated well with visual impairment in acute ON. DBSI successfully detected inflammatory cell infiltration and optic nerve white matter pathology in EAE that was consistent with histology, supporting the capability of DBSI to quantify increased cellularity, axonal injury and myelin damage in the optic nerve of EAE mice

Changes in respiratory structure and function after traumatic cervical spinal cord injury: observations from spinal cord and brain

Respiratory difficulties and mortality following severe cervical spinal cord injury (CSCI) result primarily from malfunctions of respiratory pathways and the paralyzed diaphragm. Nonetheless, individuals with CSCI can experience partial recovery of respiratory function through respiratory neuroplasticity. For decades, researchers have revealed the potential mechanism of respiratory nerve plasticity after CSCI, and have made progress in tissue healing and functional recovery. While most existing studies on respiratory plasticity after spinal cord injuries have focused on the cervical spinal cord, there is a paucity of research on respiratory-related brain structures following such injuries. Given the interconnectedness of the spinal cord and the brain, traumatic changes to the former can also impact the latter. Consequently, are there other potential therapeutic targets to consider? This review introduces the anatomy and physiology of typical respiratory centers, explores alterations in respiratory function following spinal cord injuries, and delves into the structural foundations of modified respiratory function in patients with CSCI. Additionally, we propose that magnetic resonance neuroimaging holds promise in the study of respiratory function post-CSCI. By studying respiratory plasticity in the brain and spinal cord after CSCI, we hope to guide future clinical work