Brain Function and White Matter Changes in Congenital, Acute and Chronic Spinal Cord Lesions

Study Overview
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Brief Summary
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The purpose of this study is to use functional MRI (fMRI) and magnetic resonance (MR) diffusion tensor imaging (DTI) to investigate brain activation and white matter changes in patients with congenital (birth defect of the spinal column), acute and chronic complete spinal cord lesions. The findings of this study may provide a basis to better understand the pathomechanisms underlying the dynamic neurofunctional changes following a spinal cord lesions in man. This understanding is important for the improvement of existing therapies and for the development of new therapeutic approaches.

Detailed Description
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Recently new approaches to spinal cord repair have been successfully established in animal models. Promising therapies for promoting spinal axonal regeneration in man will be available in the near future. Most research in the field is focussed on the lesion itself and the perilesional spinal cord. The recovery of motor and sensory function is,however, not permitted by local processes at the spinal level only. The whole central nervous system (CNS) reacts to such a condition. Therefore the modulation of motor and sensory function in spinal cord lesioned patients should be reflected in characteristic changes of cortical brain activity, which are accessible to new non-invasive functional neuroimaging techniques such as functional magnetic resonance imaging (fMRI). Changes of white matter due to axonal damage can also be measured qualitatively and quantitatively using MR diffusion tensor imaging (DTI). Those measures may provide a basis to better understand the pathophysiology underlying spinal cord lesions in man, including changes in brain function over time (during rehabilitation) or related to specific treatment. However, there are no studies available yet addressing those topics or providing mechanism-based approaches for determining the time interval of application of novel neuroregenerative drugs. By investigation of brain activation and white matter changes in patients with congenital(myelomeningocele (MMC)), acute and chronic spinal cord lesions (ASIA A) first and fundamental work in this field will be conducted in this study.

Official Title
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Brain Function and White Matter Changes in Congenital, Acute and Chronic Spinal Cord Lesions

Conditions
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Paraplegia, Spinal, Myelomeningocele

Intervention / Treatment
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* Other: fMRI, DTI


Participation Criteria
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Eligibility Criteria
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Inclusion criteria: Paraplegic patients (Th1-Th12, ASIA A), Myelomeningocele patients (Th1-Th12 ASIA A) Acute SCI 2-6 months, chronic SCI 12-24 months Exclusion criteria: Traumatic brain injury (TBI) Neurological diseases other than spinal cord lesion MRI incompatibility Pressure sores methicillin-resistant Staphylococcus aureus (MRSA)

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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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Chronic posttraumatic paraplegia<br>Paraplegic patients (Thoracic level of lesion Th1-Th12), ASIA A, spinal cord injury (SCI) 12-24 months | Other: fMRI, DTI<br>* functional magnetic resonance imaging (fMRI), MR diffusion tensor imaging (DTI)<br>|
| Acute posttraumatic paraplegia<br>Paraplegic patients (Thoracic level of lesion Th1-Th12), ASIA A,SCI 2-6 months, | Other: fMRI, DTI<br>* functional magnetic resonance imaging (fMRI), MR diffusion tensor imaging (DTI)<br>|
| Myelomeningocele patients<br>Myelomeningocele patients (congenital paraplegia, thoracic level of lesion Th1-Th12) ASIA A | Other: fMRI, DTI<br>* functional magnetic resonance imaging (fMRI), MR diffusion tensor imaging (DTI)<br>|
| Volunteers<br>Volunteers without any neurological deficits | Other: fMRI, DTI<br>* functional magnetic resonance imaging (fMRI), MR diffusion tensor imaging (DTI)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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functional MRI,primary motor cortex,spinal cord injury