Specific Alterations in Brain White Matter Networks and Their Impact on Clinical Function in Pediatric Patients With Thoracolumbar Spinal Cord Injury

• Published in: Journal of magnetic resonance imaging Vol. 60; no. 5; pp. 1842 - 1852
• Main Authors: Yang, Beining, Zheng, Weimin, Wang, Ling, Jia, Yulong, Qi, Qunya, Xin, Haotian, Wang, Yu, Liang, Tengfei, Chen, Xin, Chen, Qian, Li, Baowei, Du, Jubao, Hu, Yongsheng, Lu, Jie, Chen, Nan
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01.11.2024; Wiley Subscription Services, Inc
• Subjects: Adolescent; Audio data; Biomarkers; Brain; Brain - diagnostic imaging; Brain injury; Case-Control Studies; Child; Correlation; diffusion tensor imaging; Diffusion Tensor Imaging - methods; Efficiency; Female; Field strength; graph theory; Humans; Limbic system; magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Medical imaging; Neuroimaging; Parahippocampal gyrus; Patients; pediatric; Pediatrics; Prefrontal cortex; Prospective Studies; Somatosensory cortex; Spinal cord injuries; Spinal Cord Injuries - diagnostic imaging; Statistical analysis; Statistical tests; Substantia alba; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; thoracolumbar spinal cord injury; Topology; White Matter - diagnostic imaging; white matter network; diffusion tensor imaging; thoracolumbar spinal cord injury; magnetic resonance imaging; graph theory; white matter network; pediatric
• ISSN: 1053-1807; 1522-2586; 1522-2586
• DOI: 10.1002/jmri.29231

Background The alternation of brain white matter (WM) network has been studied in adult spinal cord injury (SCI) patients. However, the WM network alterations in pediatric SCI patients remain unclear. Purpose To evaluate WM network changes and their functional impact in children with thoracolumbar SCI (TSCI). Study Type Prospective. Subjects Thirty‐five pediatric patients with TSCI (8.94 ± 1.86 years, 8/27 males/females) and 34 age‐ and gender‐matched healthy controls (HCs) participated in this study. Field Strength/Sequence 3.0 T/DTI imaging using spin‐echo echo‐planar and T1‐weighted imaging using 3D T1‐weighted magnetization‐prepared rapid gradient‐echo sequence. Assessment Pediatric SCI patients were evaluated for motor and sensory scores, injury level, time since injury, and age at injury. The WM network was constructed using a continuous tracing method, resulting in a 90 × 90 matrix. The global and regional metrics were obtained to investigate the alterations of the WM structural network. topology. Statistical Tests Two‐sample independent t‐tests, chi‐squared test, Mann–Whitney U‐test, and Spearman correlation. Statistical significance was set at P < 0.05. Results Compared with HCs, pediatric TSCI patients displayed decreased shortest path length (Lp = 1.080 ± 0.130) and normalized Lp (λ = 5.020 ± 0.363), and increased global efficiency (Eg = 0.200 ± 0.015). Notably, these patients also demonstrated heightened regional properties in the orbitofrontal cortex, limbic system, default mode network, and several audio‐visual‐related regions. Moreover, the λ and Lp values negatively correlated with sensory scores. Conversely, nodal efficiency values in the right calcarine fissure and surrounding cortex positively correlated with sensory scores. The age at injury positively correlated with node degree in the left parahippocampal gyrus and nodal efficiency in the right posterior cingulate gyrus. Data Conclusion Reorganization of the WM networks in pediatric SCI patients is indicated by increased global and nodal efficiency, which may provide promising neuroimaging biomarkers for functional assessment of pediatric SCI. Evidence Level 2 Technical Efficacy Stage 5