Y Kong1, L Shi2, S C N Hui1, D Wang3, M Deng1, W C W Chu4, J C Y Cheng5. 1. From the Departments of Imaging and Interventional Radiology (Y.K., L.S., S.C.N.H., D.W., M.D., W.C.W.C.). 2. From the Departments of Imaging and Interventional Radiology (Y.K., L.S., S.C.N.H., D.W., M.D., W.C.W.C.)Shenzhen Institutes of Advanced Technology (L.S.), Chinese Academy of Sciences, Shenzhen, China. 3. From the Departments of Imaging and Interventional Radiology (Y.K., L.S., S.C.N.H., D.W., M.D., W.C.W.C.)Biomedical Engineering and Shun Hing Institute of Advanced Engineering (D.W.)The Chinese University of Hong Kong Shenzhen Research Institute (D.W.), Shenzhen, China. dfwang@cuhk.edu.hk winnie@med.cuhk.edu.hk. 4. From the Departments of Imaging and Interventional Radiology (Y.K., L.S., S.C.N.H., D.W., M.D., W.C.W.C.) dfwang@cuhk.edu.hk winnie@med.cuhk.edu.hk. 5. Orthopaedics and Traumatology (J.C.Y.C.), The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
Abstract
BACKGROUND AND PURPOSE: Disturbed somatosensory evoked potentials have been demonstrated in patients with adolescent idiopathic scoliosis (but this functional delay was found to originate above the C5-6 level, while the lower cord level was unaffected). Together with MR imaging observation of tonsillar ectopia and a relatively tethered cord, we hypothesized that there is disturbed mean diffusivity integrity along the spinal cord. In this study, advanced DTI was used to evaluate whether there was underlying decreased WM integrity within the brain stem and spinal cord in adolescent idiopathic scoliosis and any relationship to cerebellar tonsillar ectopia. Clinical impact on balance testing was also correlated. MATERIALS AND METHODS: Thirteen girls with adolescent idiopathic scoliosis with right thoracic curves were compared with 13 age-matched healthy girls. DTI of the brain and whole spinal cord was performed. ROIs were manually defined for the medulla oblongata and along each intervertebral segment of the cord. Mean values of fractional anisotropy and mean diffusivity were computed at the defined regions. Between-group comparisons were performed by 1-way ANOVA. RESULTS: Significantly decreased fractional anisotropy values and increased mean diffusivity values were found at the medulla oblongata and C1-2, C2-3, C3-4, and C4-5 segments in patients with adolescent idiopathic scoliosis compared with healthy subjects. No significant difference was found in the lower cord levels. Significant correlation was found between the tonsillar level and fractional anisotropy value at the C4-5 level in patients with adolescent idiopathic scoliosis only. CONCLUSIONS: The findings from this study are in agreement with previous findings showing abnormal somatosensory evoked potential readings occurring only above the C5-6 level in patients with adolescent idiopathic scoliosis; these findings might partially explain the pathophysiology of the neural pathway involved.
BACKGROUND AND PURPOSE: Disturbed somatosensory evoked potentials have been demonstrated in patients with adolescent idiopathic scoliosis (but this functional delay was found to originate above the C5-6 level, while the lower cord level was unaffected). Together with MR imaging observation of tonsillar ectopia and a relatively tethered cord, we hypothesized that there is disturbed mean diffusivity integrity along the spinal cord. In this study, advanced DTI was used to evaluate whether there was underlying decreased WM integrity within the brain stem and spinal cord in adolescent idiopathic scoliosis and any relationship to cerebellar tonsillar ectopia. Clinical impact on balance testing was also correlated. MATERIALS AND METHODS: Thirteen girls with adolescent idiopathic scoliosis with right thoracic curves were compared with 13 age-matched healthy girls. DTI of the brain and whole spinal cord was performed. ROIs were manually defined for the medulla oblongata and along each intervertebral segment of the cord. Mean values of fractional anisotropy and mean diffusivity were computed at the defined regions. Between-group comparisons were performed by 1-way ANOVA. RESULTS: Significantly decreased fractional anisotropy values and increased mean diffusivity values were found at the medulla oblongata and C1-2, C2-3, C3-4, and C4-5 segments in patients with adolescent idiopathic scoliosis compared with healthy subjects. No significant difference was found in the lower cord levels. Significant correlation was found between the tonsillar level and fractional anisotropy value at the C4-5 level in patients with adolescent idiopathic scoliosis only. CONCLUSIONS: The findings from this study are in agreement with previous findings showing abnormal somatosensory evoked potential readings occurring only above the C5-6 level in patients with adolescent idiopathic scoliosis; these findings might partially explain the pathophysiology of the neural pathway involved.
Authors: Defeng Wang; Youyong Kong; Lin Shi; Anil A T Ahuja; Jack C Y Cheng; Winnie C W Chu Journal: J Neurosci Methods Date: 2012-07-03 Impact factor: 2.390
Authors: Winnie C W Chu; Wynnie W M Lam; Yu-Leung Chan; Bobby K W Ng; Tsz-Ping Lam; Kwong-Man Lee; Xia Guo; Jack C Y Cheng Journal: Spine (Phila Pa 1976) Date: 2006-01-01 Impact factor: 3.468
Authors: Julio Domenech; G García-Martí; L Martí-Bonmatí; C Barrios; J M Tormos; A Pascual-Leone Journal: Eur Spine J Date: 2011-04-16 Impact factor: 3.134
Authors: Winnie C W Chu; Gene C W Man; Wynnie W M Lam; Benson H Y Yeung; W W Chau; Bobby K W Ng; Tsz-ping Lam; Kwong-man Lee; Jack C Y Cheng Journal: Spine (Phila Pa 1976) Date: 2008-03-15 Impact factor: 3.468
Authors: Saad Jbabdi; Stamatios N Sotiropoulos; Alexander M Savio; Manuel Graña; Timothy E J Behrens Journal: Magn Reson Med Date: 2012-02-14 Impact factor: 4.668