Microstructural alterations of major thalamic nuclei in the chronic pediatric spinal cord injured population

K Kang; K Fleming; A Sathe; J Muller; J Harrop; D Middleton; J E Heller; A Sharan; F Mohamed; L Krisa; M Alizadeh

doi:10.1016/j.wnsx.2023.100268

Microstructural alterations of major thalamic nuclei in the chronic pediatric spinal cord injured population

World Neurosurg X. 2023 Dec 10:21:100268. doi: 10.1016/j.wnsx.2023.100268. eCollection 2024 Jan.

Authors

K Kang¹, K Fleming¹, A Sathe¹, J Muller¹, J Harrop², D Middleton¹, J E Heller², A Sharan², F Mohamed¹, L Krisa¹, M Alizadeh³

Affiliations

¹ Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St., Philadelphia, PA, 19107, USA.
² Department of Neurosurgery, Thomas Jefferson University, 909 Walnut Street, 2nd Floor, Philadelphia, PA, 19107, USA.
³ Department of Neurosurgery, Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, 909 Walnut St., Philadelphia, PA, 19107, USA.

Abstract

Background: The brain undergoes reorganization following spinal cord injury (SCI), but little is known about how the thalamus is affected in pediatric SCIs.

Purpose: To characterize microstructural alterations in the thalamus after SCI with diffusion tensor imaging (DTI) metrics.

Methods: 18 pediatric participants with chronic SCI (8-20 years) were stratified using the American Spinal Injury Association Impairment Scale (AIS) into groups: A, B, and C/D. DTI of the brain used a 3 T Siemens Verio MRI using the parameters: 20 directions, number of averages = 3, b = 1000 s/mm², voxel size = 1.8 mm × 1.8 mm, slice thickness = 5 mm, TE = 95 ms, TR = 4300 ms, 30 slices, FOV = 230 × 230 mm², matrix = 128 × 128, acquisition time = 4:45 min. Diffusion data was processed to generate DTI metrics FA, MD, AD, and RD.

Data analysis: DTI metrics were acquired by superimposing the AAL3 thalamic atlas onto participant diffusion images registered to MNI152 space. We utilized a multiple Mann-Whitney U-test to compare between AIS groups, considering values of p ≤ 0.05 as significant.

Results: FA, AD, RD, and MD significantly differed in thalamic nuclei between AIS groups A vs B and B vs C/D. Significant nuclei include the right ventral anterior, left intralaminar, bilateral lateral pulvinar, and right lateral geniculate.

Conclusion: Our findings suggest the presence of microstructural alterations based on SCI severity in pediatric patients. These results are encouraging and warrant further study.

Keywords: Diffusion tensor imaging; Magnetic resonance imaging; Pediatrics; Spinal cord injury; Thalamus.