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首页> 外文期刊>Neurorehabilitation and neural repair >Metabolic changes in the spinal cord after brachial plexus root re-implantation
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Metabolic changes in the spinal cord after brachial plexus root re-implantation

机译：臂丛神经根再植入后脊髓的代谢变化

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Objective. To investigate metabolic changes within the spinal cord using proton magnetic resonance spectroscopy (1H-MRS) and determine their relationship with clinical function in patients with complete brachial plexus avulsion who underwent reimplantation of the ventral roots. Methods. Single-voxel 1H-MRS of the cord between C1 and C3 was performed in 10 patients with normal spinal cord on MRI, who underwent reimplantation of C5 to T1 ventral roots on average 5.5 years earlier, and 19 healthy controls. The ratios of the concentrations of the following main metabolites, with respect to total creatine levels, were obtained: total N-acetyl-aspartate, choline-containing compounds, creatine and phosphocreatine (Cr), and myo-inositol (m-Ins). Patient disability was assessed using upper limb scales. Differences in metabolite concentration ratios and their correlations with disability were investigated. Results. Patients showed increased m-Ins/Cr ratio compared with controls, which was associated with the level of function of the affected arm and time from injury. Conclusions. The finding of increased m-Ins/Cr in patients suggests that reactive gliosis, perhaps in response to the degeneration of avulsed fibers, may occur in the spinal cord above the site of injury and be relevant to motor dysfunction. However, this pathological process appears to diminish with time. These insights underline the need to integrate metabolic imaging with structural and functional magnetic resonance imaging to obtain a complete view of spinal cord plasticity. Last, this study provides the first steps toward identifying markers to serve as outcome measures for trials comparing strategies of plexus repair following avulsion injury.
机译：目的。使用质子磁共振波谱（1H-MRS）调查脊髓内的代谢变化，并确定其与腹侧根再植的完全臂丛神经撕脱伤患者的临床功能之间的关系。方法。在10例MRI脊髓正常的患者中进行了C1和C3之间的脊髓单体素1H-MRS，他们平均5.5年前接受了C5到T1腹侧根的再植入，并进行了19位健康对照。获得以下主要代谢物的浓度相对于总肌酸水平的比率：总N-乙酰天门冬氨酸，含胆碱的化合物，肌酸和磷酸肌酸（Cr）和肌醇（m-Ins）。使用上肢量表评估患者的残疾。研究了代谢物浓度比的差异及其与残疾的相关性。结果。与对照组相比，患者的m-Ins / Cr比值升高，这与患肢的功能水平和受伤时间有关。结论患者中m-Ins / Cr升高的发现表明，反应性神经胶质增生，可能是由于撕脱纤维的变性所致，可能发生在受伤部位上方的脊髓中，与运动功能障碍有关。但是，这种病理过程似乎随着时间的推移而减弱。这些见解强调了将代谢成像与结构和功能磁共振成像相集成以获得脊髓可塑性的完整视图的必要性。最后，这项研究提供了鉴定标记物的第一步，以作为比较撕脱伤后神经丛修复策略的试验的结果指标。

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