title: Clinical correlates of cerebral diffusion tensor imaging findings in chronic traumatic spinal cord injury.
abstract: METHODS
  Prospective clinical case-control study.
  
  
  OBJECTIVE
  The aim of this study was to use diffusion tensor imaging (DTI) to assess the state of cerebral white matter tracts after spinal cord injury (SCI). The DTI metrics were evaluated in relation to neurological deficits and to the size and level of the spinal cord lesions.
  
  
  METHODS
  Tampere University Hospital, Tampere, Finland.
  
  
  METHODS
  Thirty-four patients (n=34) with clinically complete and incomplete SCI were evaluated using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). DTI metrics (fractional anisotropy (FA) and apparent diffusion coefficient (ADC)) were calculated for multiple levels along the course of the corticospinal tract. The state of the spinal cord after injury was assessed using conventional magnetic resonance imaging (MRI). DTI parameters were compared with 40 orthopedically injured control subjects.
  
  
  RESULTS
  Statistically significant differences in the DTI values between patients and controls were detected in the posterior area of the centrum semiovale. In this area, the FA values were lower in the patients compared with controls (P=0.008). For patients with clinically complete injury, the difference was even more significant (P=0.0005). Motor and sensory scores of the ISNCSCI correlated positively with FA and negatively with ADC values of the centrum semiovale. A moderate association was observed between the macroscopic changes in the spinal cord and the DTI abnormalities in the centrum semiovale.
  
  
  CONCLUSIONS
  In patients with chronic SCI, DTI changes can be observed in the cerebral white matter. These alterations are associated with the clinical state of the patients.
authors.affiliation: Department of Neuroscience and Rehabilitation, Tampere University Hospital, Tampere, Finland.
authors.forename: E A
authors.initials: EA
authors.lastname: Koskinen
authors.affiliation: 1] Department of Radiology, Medical Imaging Centre of Pirkanmaa Hospital District, Tampere, Finland [2] Department of Electronics and Communications Engineering, Tampere University of Technology, Tampere, Finland.
authors.forename: U
authors.initials: U
authors.lastname: Hakulinen
authors.affiliation: Department of Radiology, Medical Imaging Centre of Pirkanmaa Hospital District, Tampere, Finland.
authors.forename: A E
authors.initials: AE
authors.lastname: Brander
authors.affiliation: Department of Neuroscience and Rehabilitation, Tampere University Hospital, Tampere, Finland.
authors.forename: T M
authors.initials: TM
authors.lastname: Luoto
authors.affiliation: 1] Department of Neurological Sciences, University of Helsinki, Helsinki, Finland [2] Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Ylinen
authors.affiliation: 1] Department of Neuroscience and Rehabilitation, Tampere University Hospital, Tampere, Finland [2] School of Medicine, University of Tampere, Tampere, Finland.
authors.forename: J E
authors.initials: JE
authors.lastname: Ohman
mesh_terms: D000293:Adolescent; D000328:Adult; D016880:Anisotropy; D001930:Brain Injuries / Q000473:pathology / Q000503:physiopathology; D016022:Case-Control Studies; D002908:Chronic Disease; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013116:Spinal Cord / Q000473:pathology*; D013119:Spinal Cord Injuries / Q000473:pathology* / Q000503:physiopathology; D055815:Young Adult