Many neurological diseases arise initially from a focal lesion. Only with time neurodegeneration spreads to other brain areas and the spinal cord – a phenomena called diaschisis. Currently, neuroimaging studies are performed separately in the brain and spinal cord. However, to capture neurodegeneration across the central nervous system (CNS), a simultaneous analysis tool is required. Patrick Freund from the Spinal Cord Injury Center (University Hospital Balgrist) and colleagues from UCL (UK) and the UCSF (US) combined methods to examine the disrupted structure-function relationship within the spinal cord and brain required for movement recovery.
A strategic alliance with researchers from the UK and the USA, allowed Freund and colleagues to combine voxel-based morphometry with a brain-spinal cord template and apply it to anatomical scans covering the brain and cervical cord from patients with multiple sclerosis and healthy controls. This enabled them to quantify simultaneously changes in the volume of the brain and the cervical cord.
The proposed method proved sensitive to detect a severity-dependent pattern of degeneration both in the spinal cord and brain. In particular, the magnitude of changes in the spinal cord were significantly associated with motor performance loss while changes in the brain were associated with cognitive impairment.
These findings suggest that the approach is valid for assessing spatially distributed neurodegeneration and structural and functional changes due to reorganization in the entire CNS and for all neurological diseases involving the spine and brain.
By: Patrick Freund – Spinal Cord Injury Center Balgrist, University Hospital Zurich, University of Zurich, Zurich, Switzerland
Reference: Freund, P., Papinutto, N., Bischof, A., Azzarito, M., Kirkish, G., Ashburner, J., Thompson, A., Hauser, S.L., Henry, R.G. Simultaneous assessment of regional distributions of atrophy across the neuraxis in MS patients. Neuroimage Clin (2022)