Outcome Evaluation with Signal Activation of Functional MRI in Spinal Cord Injury.

Jung, Jong Kwon; Oh, Chang Hyun; Yoon, Seung Hwan; Ha, Yoon; Park, Sora; Choi, Byunghyune

doi:2011.50.3.209

Original Article

Journal of Korean Neurosurgical Society 2011;50(3): 209-215.
doi: https://doi.org/10.3340/jkns.2011.50.3.209

Outcome Evaluation with Signal Activation of Functional MRI in Spinal Cord Injury.

Jong Kwon Jung, Chang Hyun Oh, Seung Hwan Yoon, Yoon Ha, Sora Park, Byunghyune Choi

¹Department of Anesthesiology, Inha University Hospital, Incheon, Korea.
²Seoul Regional Military Manpower Administration, Seoul, Korea.
³Department of Neurosurgery, Inha University Hospital, Incheon, Korea. nsyoon@gmail.com
⁴Inha Neural Repair Center, Inha University Hospital, Incheon, Korea.
⁵Department of Neurosurgery, Yonsei Severance Hospital University, Seoul, Korea.
⁶Department of Physiology, Inha University College of Medicine, Incheon, Korea.
⁷Inha Research Institute for Medical Sciences, Inha University Hospital, Incheon, Korea.

ABSTRACT

OBJECTIVE
The authors investigated the changes of cortical sensorimotor activity in functional MRI (fMRI) and functional recovery in spinal cord injury (SCI) patients who had been treated by bone marrow cell transplantation.
METHODS
Nineteen patients with SCI were included in this study; ten patients with clinical improvement and nine without. The cortical sensorimotor activations were studied using the proprioceptive stimulation during the fMRI.
RESULTS
Diagnostic accuracy of fMRI with neurological improvement was 70.0% and 44.4% for sensitivity and specificity, respectively. Signal activation in the ipsilateral motor cortex in fMRI was commonly observed in the clinically neurological improved group (p-value=0.002). Signal activation in the contralateral temporal lobe and basal ganglia was more commonly found in the neurological unimproved group (p-value<0.001). Signal activation in other locations was not statistically different.
CONCLUSION
In patients with SCI, activation patterns of fMRI between patients with neurologic recovery and those without varied. Such plasticity should be considered in evaluating SCI interventions based on behavioral and neurological measurements.

Key Words: Sensorimotor; Functional MRI; Spinal cord injury; Bone marrow cell; Proprioceptive