Title

Lateral corticospinal tract and dorsal column damage: predictive relationships with motor and sensory scores at discharge from acute rehabilitation after spinal cord injury

College

Rueckert-Hartman College for Health Professions

Document Type

Article

Publication Date

2021

Abstract

Objective: to determine if lateral corticospinal tract (LCST) integrity demonstrates a significant predictive relationship with future ipsilateral lower extremity motor function (LEMS), and if dorsal column (DC) integrity demonstrates a significant predictive relationship with future light touch (LT) sensory function post SCI at time of discharge from inpatient rehabilitation.

Design: retrospective analyses of imaging and clinical outcomes.

Setting: University and academic hospital.

Participants: 151 participants with SCI.

Interventions: Inpatient rehabilitation.

Main outcome measures: LEMS and LT scores at discharge from inpatient rehabilitation.

Results: In 151 participants, right LCST spared tissue demonstrated a significant predictive relationship with right LEMS percent recovered (β = 0.56, 95% CI: 0.37, 0.73, R = 0.43, p < 0.001). Left LCST spared tissue demonstrated a significant predictive relationship with left LEMS percent recovered (β = 0.66, 95% CI: 0.50, 0.82, R = 0.51, p < 0.001). DC spared tissue demonstrated a significant predictive relationship with LT percent recovered (β = 0.69, 95% CI: 0.52, 0.87, R = 0.55, p < 0.001). When subgrouping the participants into motor complete versus incomplete SCI, motor relationships were no longer significant but the sensory relationship remained significant. Those who had no voluntary motor function but recovered some also had significantly greater LCST spared tissue compared to those who did not recover motor function.

Conclusions: LCST demonstrated significant moderate predictive relationships with lower extremity motor function at the time of discharge from inpatient rehabilitation, in an ipsilesional manner. DC integrity demonstrated a significant moderate predictive relationship with recovered function of LT. With further development, these neuroimaging methods might be used to predict potential deficits following SCI and to provide corresponding targeted interventions.

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