Diffusion Tensor (DTI) for the Assessement of Therapeutic Evolution of Patients With Acute Lumbar Radiculalgia

Study Overview
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Brief Summary
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Diffusion tensor imaging (DTI) is a non-invasive MRI technique offering a functional approach that provides morphological information about the microstructures of the nerve roots. DTI is a widely used neuroimaging technique and is a current topic of research in the field of peripheral nerve imaging.The aim of the study is to determine the prognostic quality of the DTI parameters to predict the therapeutic evolution of patients with lumbar radiculalgia at 6 months.

Official Title
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Prognostic Value Assessment of Biomarkers in Acute Lumbar Radiculalgia : Contribution of the Diffusion Tensor in Magnetic Resonance Imaging

Conditions
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Lumbar Radiculopathy, Magnetic Resonance Imaging, Diffusion Tensor Imaging

Intervention / Treatment
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* Other: DTI sequence acquisition


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Age ≥ 18 ans Patient with Lumbar Radiculalgia (L4, L5 or S1) Pain VAS (Visual analog scale) > 30/100 Less than 3 months of evolution With a radiculalgia superior or equal to lumbalgia Disco radicular conflict, verified by MRI Able to receive information Affiliated to French social security Exclusion Criteria: History of chronic lumbalgia and radiculalgia History of lumbar surgery Recent episode (less than 6 months) with the same radicular topography Bilateral radicular compression on MRI Patient requiring emergency surgery Evolutive disease interfering with pain assesment (neoplasia, inflammatory rheumatism, peripheral neuropathy, central neurological disease) MRI contraindication

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Lumbar radiculopathy<br>Patients with acute lumbar radiculopathy (less than 3 months of evolution) | Other: DTI sequence acquisition<br>* DTI sequence acquisition<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Predictive performance of DTI imaging on the therapeutic evolution | DTI is a sensitive probe of cellular structure that works by measuring the diffusion of water molecules. The measured quantity is the diffusion coefficient, a proportionality constant that relates diffusive flux to a concentration gradient and has units of mm2/s. The objective is to know if the interpretation of DTI allow to predict the therapeutic evolution of patients. For instance, the patients will need in the future oral drugs? Or they will need rather an infiltration? Or they will need rather a surgery? | 6 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between DTI parameters and pain intensity | DTI is a sensitive probe of cellular structure that works by measuring the diffusion of water molecules. The measured quantity is the diffusion coefficient, a proportionality constant that relates diffusive flux to a concentration gradient and has units of mm2/s. The intensity of pain will be self evaluated by the visual analogue scale (VAS). This scale is between 0 and 10 (in cms) being absence of pain and 10 intolerable pain. | 6 months | 
| Correlation between DTI parameters evolution and neuropathic pain | DTI is a sensitive probe of cellular structure that works by measuring the diffusion of water molecules. The measured quantity is the diffusion coefficient, a proportionality constant that relates diffusive flux to a concentration gradient and has units of mm2/s. The presence of neuropathic pain will be evaluated by the Neuropathic Pain Symptom Inventory (NPSI) scale. This is a self-questionnaire.The tool evaluates mean pain intensity in the last 24h in a verbal numeric scale from zero (no pain) to 10 (worst imaginable pain). Total pain intensity score may be calculated by the sum of 10 descriptors. | 6 months | 
| Correlation between DTI parameters evolution and disability | DTI is a sensitive probe of cellular structure that works by measuring the diffusion of water molecules. The measured quantity is a diffusion coefficient, a proportionality constant that relates diffusive flux to a concentration gradient and has units of mm2/s. The disability will be measured by the Oswestry Disability Index (ODI). The final score/index ranges from 0-100. A score of 0-20 reflects minimal disability, 21-40 moderate disability, 41-60 severe disability, 61-80 crippled, and 81-100 bed-bound. | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Lumbar Radiculopathy, Magnetic Resonance Imaging, Diffusion Tensor Imaging, Prognostic