Injuries to the spinal cord result in tissue loss in the spinal cord and brain. These neurodegenerative changes can be analyzed in detail using neuroimaging methods. UZH researchers have now for the first time been able to reliably predict the extent of functional recovery in patients suffering from a spinal cord injury two years after a trauma based on the extent and progression of neurodegenerative changes within the first six months after injury.
A trauma to the spinal cord, quickly leads to a progressive loss of nerve tissue. This not only affects the injured area, but over time affects also other parts of the spinal cord and even the brain. These neurodegenerative changes can be explored in detail using magnetic resonance imaging.
An international team of researchers headed up by Patrick Freund from the Spinal Cord Injury Center of the University of Zurich and the Balgrist University Hospital has now for the first time investigated the extent and progression of microstructural changes over the first two years after a spinal cord injury.
The smaller the initial nerve loss, the better the long-term recovery
In their study, the scientists examined 15 patients who had suffered acute traumatic injuries to the spinal cord as well as 18 healthy study participants after 2, 6, 12, and 24 months. In the brain as well as spinal cord, they determined the anatomical extent of neurodegeneration, the loss of myelin (the insulating layer surrounding nerve cells), as well as the accumulation of iron in the nerve tissue as a result of degeneration and inflammation.
It then emerged that there was a direct link between the recovery levels of patients after two years and the extent of neurodegenerative change within the first six months after injury. “The smaller the overall loss of nerve tissue across the neuroaxis at the beginning, the better the patients’ long-term clinical recovery,” summarizes Patrick Freund.
Predicting long-term recovery by measuring early changes
What the researchers found surprising was the fact that the recovery was steepest within the first six months but neurodegenerative changes greatest within the same time period with no signs of deceleration over two years in the spinal cord and brain. This indicates a fierce competition between compensatory and neurodegenerative changes early after injury. The battle seems to be lost in favor of neurodegeneration over time.
Nevertheless, the magnitude of early microstructural changes is predictive of the long term recovery of patients suffering from a spinal cord injury. Crucially, non-invasive, high-resolution neuroimaging provides a mean to predict recovery trajectories and distinguish between neurodegeneration caused by the spinal cord injury itself and beneficial changes resulting from therapy.
“We have now a tool to reliably predict recovery and determine the effects of treatments and rehabilitation measures as opposed to spontaneous neurodegeneration in humans” adds neuroimaging specialist Freund. “Clinical studies can thus be carried out more efficiently and cost-effectively in the future.”
Clinical studies into the influence of arm and leg exercises planned
The patients who took part in the study will be examined again after five years using the same method. The scientists want to determine whether the neurodegenerative changes will have ceased by then or whether they will still be ongoing. Patrick Freund and his team are also planning training studies that aim to show whether the high-intensity exercising of arm and leg functions helps to slow down or stop the loss of nerve tissue.
Gabriel Ziegler, Patrick Grabher, Alan Thompson, Daniel Altmann, Markus Hupp, John Ashburner, Karl Friston, Nikolaus Weiskopf, Armin Curt, and Patrick Freund. Progressive neurodegeneration following spinal cord injury: implications for clinical trials. Neurology. March 7, 2018. DOI: 10.1212/WNL.0000000000005258
PD Patrick Freund, MD, PhD
Spinal Cord Injury Center, Research
Balgrist University Hospital
University of Zurich
Phone +41 44 510 72 11
Kurt Bodenmüller | Universität Zürich
Link between Gut Flora and Multiple Sclerosis Discovered
15.10.2018 | Universität Zürich
Storage & Transport of highly volatile Gases made safer & cheaper by the use of “Kinetic Trapping"
15.10.2018 | Universität Augsburg
Augsburg chemists present a new technology for compressing, storing and transporting highly volatile gases in porous frameworks/New prospects for gas-powered vehicles
Storage of highly volatile gases has always been a major technological challenge, not least for use in the automotive sector, for, for example, methane or...
When we put water in a freezer, water molecules crystallize and form ice. This change from one phase of matter to another is called a phase transition. While this transition, and countless others that occur in nature, typically takes place at the same fixed conditions, such as the freezing point, one can ask how it can be influenced in a controlled way.
We are all familiar with such control of the freezing transition, as it is an essential ingredient in the art of making a sorbet or a slushy. To make a cold...
Thin organic layers provide machines and equipment with new functions. They enable, for example, tiny energy recuperators. In future, these will be installed...
Das Zusammenspiel aus Struktur und Dynamik bestimmt die Funktion von Proteinen, den molekularen Werkzeugen der Zelle. Durch Fortschritte in der...
New measurement method allows researchers to precisely follow the movement of individual molecules over long periods of time
The function of proteins – the molecular tools of the cell – is governed by the interplay of their structure and dynamics. Advances in electron microscopy have...
02.10.2018 | Event News
01.10.2018 | Event News
21.09.2018 | Event News
15.10.2018 | Physics and Astronomy
15.10.2018 | Life Sciences
15.10.2018 | Life Sciences