University of Zurich researchers suggest the possibility of predicting the extent of functional recovery in spinal cord injury patients 2 years after the injury based on the extent and progression of neurodegenerative changes within the first 6 months after injury.

The international team of researchers, led by Patrick Freund from the Spinal Cord Injury Center of the University of Zurich and the Balgrist University Hospital, examined 15 patients who had suffered acute traumatic injuries to the spinal cord as well as 18 healthy study participants after 2, 6, 12, and 24 months.

The results of their investigation are published in a recent issue of Neurology.

In the brain as well as spinal cord, they determined the anatomical extent of neurodegeneration, the loss of myelin (the insulating layer surrounding nerve cells), as well as the accumulation of iron in the nerve tissue as a result of degeneration and inflammation. It then emerged that there was a direct link between the recovery levels of patients after 2 years and the extent of neurodegenerative change within the first 6 months after injury, explains a media release from the University of Zurich.

“The smaller the overall loss of nerve tissue across the neuroaxis at the beginning, the better the patients’ long-term clinical recovery,” Freund summarizes.

According to the researchers, recovery was steepest within the first 6 months but neurodegenerative changes were greatest within the same time period with no signs of deceleration over 2 years in the spinal cord and brain. This indicates a fierce competition between compensatory and neurodegenerative changes early after injury. The battle seems to be lost in favor of neurodegeneration over time.

Nevertheless, the magnitude of early microstructural changes is predictive of the long term recovery of patients suffering from a spinal cord injury. Crucially, non-invasive, high-resolution neuroimaging provides a mean to predict recovery trajectories and distinguish between neurodegeneration caused by the spinal cord injury itself and beneficial changes resulting from therapy, the release continues.

“We have now a tool to reliably predict recovery and determine the effects of treatments and rehabilitation measures as opposed to spontaneous neurodegeneration in humans,” adds Freund, a neuroimaging specialist. “Clinical studies can thus be carried out more efficiently and cost-effectively in the future.”

The researchers plan to examine the study participants again after 5 years using the same method, to determine whether the neurodegenerative changes will have ceased by then or whether they will still be ongoing.

They are also planning training studies to demonstrate whether the high-intensity exercising of arm and leg functions helps to slow down or stop the loss of nerve tissue.

[Source(s): University of Zurich, Science Daily]