CNS Changes Following SCI

Study Overview
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Brief Summary
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The objective of this study is to better understand the structural and functional changes that the central nervous system (CNS) undergoes following spinal cord injury and how these changes relate to clinical measures. Both macroscopic and microscopic changes of the brain and the spinal cord will be examined in SCI patients and compared to healthy controls. In terms of structural plasticity, we aim to identify MR biomarkers that allow predicting the course of the patient's neurological status and accurately describe the course of the disease and the recovery. Importantly, we aim to investigate which factors scale the patients' symptoms. In terms of functional plasticity, we will combine fMRI with behavioural testing to understand which clinical and behavioural determinants drive functional hand representations in the primary somatosensory and motor cortices to be maintained and which determinants drive reorganisation of functional representations following sensory input loss. We will further investigate the contribution of brainstem reorganisation to plasticity observed at the cortical level and, by doing so, aim to better understand the mechanistic underpinnings of functional reorganisation.

Official Title
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Functional, Structural, and Metabolic Central Nervous System Changes Following Damage of the Central Nervous System

Conditions
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Spinal Cord Injuries

Intervention / Treatment
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* Diagnostic Test: MRI
* Diagnostic Test: MRI


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria - Patients: Age 18-75 Traumatic or non-traumatic spinal cord injury (para- and tetraplegia) Acute (<4 weeks post SCI) to chronic SCI (> 6 months post SCI) Signed informed consent Exclusion Criteria - Patients: Contraindications to magnetic resonance imaging Neurological impairment of body function impairments not induced by spinal cord injury BMI > 40 Pregnancy Claustrophobia Inclusion Criteria - Healthy subjects: Age 18-75 Signed Informed consent Exclusion Criteria - Healthy subjects: Contraindications to magnetic resonance imaging Pregnancy Neurological illness Impairment of body function induced by a spinal cord injury Claustrophobia BMI > 40

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 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 |
| --- | --- |
| Patients with spinal cord injury<br> | Diagnostic Test: MRI<br>* We will examine acute (<4 weeks post SCI) to chronic (>6 months post SCI) patients using functional, structural, and metabolic MRI in both the brain and the spinal cord.<br>|
| Healthy subjects<br> | Diagnostic Test: MRI<br>* We will examine healthy control participants using functional, structural, and metabolic MRI in both the brain and the spinal cord.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Conventional magnetic resonance imaging (MRI) parameter | Structural characteristics in the brain and cervical spinal cord are assessed in acute to chronic spinal cord injury (SCI) patients using conventional MRI and compared to healthy controls | Up to 50 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Magnetic resonance spectroscopy (MRS) parameter | Metabolic parameters are assessed in acute to chronic SCI patients using MRS in the brain and cervical spinal cord and compared to healthy controls | Up to 50 weeks | 
| Change of functional MRI (fMRI) parameter between 2 to 4 time points | Change of brain activities is assessed between 2 to 4 time points using fMRI during resting-state or a specific task in acute to chronic SCI patients and compared to healthy controls | Up to 50 weeks |