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Progressive ventricles enlargement and CSF volume increases as a marker of neurodegeneration in SCI patients: A longitudinal MRI study


Seif, Maryam; Ziegler, Gabriel; Freund, Patrick (2018). Progressive ventricles enlargement and CSF volume increases as a marker of neurodegeneration in SCI patients: A longitudinal MRI study. Journal of Neurotrauma, 35(24):2941-2946.

Abstract

Next to grey and white matter atrophy, cerebrospinal fluid (CSF) volume and ventricular dilation may be surrogate biomarkers for brain atrophy in spinal cord injury (SCI). We therefore aimed to track brain atrophy by means of CSF volume changes and ventricular enlargements over two years following SCI. Fifteen SCI patients and 18 healthy controls underwent a series of T1-weighted scans during five time-points over two years. Changes of CSF/ Intracranial volume (CSF/ICV) ratio and ventricular enlargement rate over time were determined. Sample sizes with 80% power and 5% significance were calculated to detect a range of treatment effects for a two-armed trial. There was a significant cross-sectional increased CSF/ICV ratio in patients compared with controls at each time point (P<0.02). However, the rate of CSF/ICV changes was not significantly different between groups over time. CSF volume increased linearly over bilateral sensorimotor cortices (left: P=0.002, right: P=0.042) and in the supracerebellar space (P<0.001) within two years. An acceleration of the enlargement within the third (P=0.017) and the fourth (P=0.006) ventricles was observed in patients. Sample size estimation for six-month trials with CSF volume requires 25 patients per treatment arm to detect a hypothetical treatment effect in terms of slowing of atrophy rate of 30%. This study shows that SCI-induced changes in CSF/ICV ratio and ventricular expansion rate provide additional information on the neurodegenerative processes following injury. The sensitivity to scoring treatment effects speaks to its potential to serve as a sensitive biomarker in addition to local atrophy measures.

Abstract

Next to grey and white matter atrophy, cerebrospinal fluid (CSF) volume and ventricular dilation may be surrogate biomarkers for brain atrophy in spinal cord injury (SCI). We therefore aimed to track brain atrophy by means of CSF volume changes and ventricular enlargements over two years following SCI. Fifteen SCI patients and 18 healthy controls underwent a series of T1-weighted scans during five time-points over two years. Changes of CSF/ Intracranial volume (CSF/ICV) ratio and ventricular enlargement rate over time were determined. Sample sizes with 80% power and 5% significance were calculated to detect a range of treatment effects for a two-armed trial. There was a significant cross-sectional increased CSF/ICV ratio in patients compared with controls at each time point (P<0.02). However, the rate of CSF/ICV changes was not significantly different between groups over time. CSF volume increased linearly over bilateral sensorimotor cortices (left: P=0.002, right: P=0.042) and in the supracerebellar space (P<0.001) within two years. An acceleration of the enlargement within the third (P=0.017) and the fourth (P=0.006) ventricles was observed in patients. Sample size estimation for six-month trials with CSF volume requires 25 patients per treatment arm to detect a hypothetical treatment effect in terms of slowing of atrophy rate of 30%. This study shows that SCI-induced changes in CSF/ICV ratio and ventricular expansion rate provide additional information on the neurodegenerative processes following injury. The sensitivity to scoring treatment effects speaks to its potential to serve as a sensitive biomarker in addition to local atrophy measures.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Balgrist University Hospital, Swiss Spinal Cord Injury Center
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:CEREBROSPINAL FLUID, MRI, spinal cord injury
Language:English
Date:15 December 2018
Deposited On:27 Jul 2018 15:44
Last Modified:19 Dec 2018 02:02
Publisher:Mary Ann Liebert
ISSN:0897-7151
OA Status:Closed
Publisher DOI:https://doi.org/10.1089/neu.2017.5522
PubMed ID:29993326

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