To study for Evaluation of correlation among quantitative magnetization transfers magnetic resonance imaging findings in an acute spinal cord injury with clinical profile and neurological outcome.
- Conditions
- Acquired deformity of musculoskeletal system, unspecified,
- Registration Number
- CTRI/2023/11/060335
- Lead Sponsor
- Pt. B.D. Sharma PGIMS Rohtak
- Brief Summary
Spinal cord injuries (SCIs) are a leading cause of disability and canlead to devastating consequences for patients. Traumatic lesions (includingprimary and secondary lesions) not only can induce a physical discontinuity ofthe tracts but also anterograde Wallerian demyelination as well as someretrograde degeneration. After SCI, some pathways may be preserved and contributeto recovery of function. This could be achieved by regeneration of pathways orsprouting of undamaged pathways. Whereas in the first case, pathways are replaced byregenerated fibres, in thesecond case, new connections are either made or strengthened through existingstructures. Thus, damage to the corticospinal tract can be in part offset bysprouting new connections through propriospinal or reticulospinal pathways,which then act more or less as a new (or enhanced relay) between the cortex andthe spinal cord. It is thus important to develop prognostic imaging tools thatwill allow the characterization of the damaged tracts and the state of residualtracts.
Injury may disrupt the normal functions of the spinal cord,and lead to severe sensory and motor behavioural deficits. Over time, theimpaired functions may recover through different mechanisms at both the Spinal Cordand brain levels. Regeneration of injured Spinal Cord is a keyprocess during functional recovery, and has been a major topic of research fordeveloping improved therapies. SCI can induce cell death and create tissuecavities, while subsequent reactions including inflammation can stimulate bothdestructive and reparative processes, and lead to edema and cystsanddemyelination. SCI also culminates in glial scarring, and the scartissue may contain secreted and transmembrane molecular inhibitors of axongrowth. To be able to evaluate potential new treatments, it isimportant to understand the temporal changes and recovery of injured SC tissuefrom structural, functional and molecular perspectives. Non-invasivequantitative magnetic resonance imaging (MRI) methods are well suited for monitoring the recovery process in acomprehensive way. Furthermore, validation of MRI measures of compositional andstructural changes that occur at and around spinal lesion sites is crucial forthe interpretation of MRI findings.
Magnetization transfer (MT) is the spin exchange betweenproton pools in different environments, and can be used to evaluatemacromolecular content of tissue. There are two main approaches tomeasure MT effects: semiquantitative magnetization transfer ratio (MTR) and Quantitativemagnetization transfer (qMT) methods that extract numerical parameters based ona specific model. To date, simpler metrics such as MTRhave beenthe major approach to assess changes in macromolecular composition inneurological disorders. MTR has also been shown to be sensitive tochanges in protein content and has been used previously in studies of SC. The sensitivity and reproducibility of MTR measure can be influenced by variousexperimental parameters. To increase specificity and sensitivity, qMT methodshave been developed to measure intrinsic MT parameters, and to isolate the poolsize ratio (PSR, the ratio of the macromolecular proton pool to the free waterpool) from relaxation rates and exchange rates.
Free water protons are observed withconventional MRI, there are additional protons residing on immobilemacromolecules in tissue. Conventional MRI cannot image these protons directlybecause their T2 relaxation times are too short (≈10 μs) to be captured by typical readoutschemes. However, these macromolecular protons communicate with the surroundingwater and, thus, can be indirectly imaged by exploiting this exchange, which isreferred to as the MT effect. Importantly, MT imaging can serve as a surrogatemarker for white matter myelin density in nervous system tissue and, therefore,may be a more specific biomarker of disease evolution.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- Not Yet Recruiting
- Sex
- All
- Target Recruitment
- 35
- 1.Patients aged between 18-65 years of both sex with acute Spinal Cord Injury.
- 2.Patients who give consent to participate in the study.
- 1.Patients with non-traumatic cause for Spinal Cord Injury.
- 2.Patients with head injury/medically unstable condition 3.Patients with previous implanted metallic devices.
- 4.Patients with claustrophobia, pacemakers and cochlear implants, gunshot wounds.
Study & Design
- Study Type
- Observational
- Study Design
- Not specified
- Primary Outcome Measures
Name Time Method 1.Maximum spinal cord compression (MSCC) At the first visit of the patient after diagnosis of spinal cord injury 2.Maximum canal compromise At the first visit of the patient after diagnosis of spinal cord injury 5.Lesion area At the first visit of the patient after diagnosis of spinal cord injury 3.Lesion length At the first visit of the patient after diagnosis of spinal cord injury 4.Lesion width At the first visit of the patient after diagnosis of spinal cord injury 6.Edema At the first visit of the patient after diagnosis of spinal cord injury 7.Magnetization transfer ratio(MTR) At the first visit of the patient after diagnosis of spinal cord injury
- Secondary Outcome Measures
Name Time Method NA NA
Trial Locations
- Locations (1)
Pt. B.D. Sharma, PGIMS Rohtak, Haryana
🇮🇳Rohtak, HARYANA, India
Pt. B.D. Sharma, PGIMS Rohtak, Haryana🇮🇳Rohtak, HARYANA, IndiaDr Chandra Moul TiwariPrincipal investigator9761743054tiwarichandramoul@gmail.com