中国神经再生研究(英文版) ›› 2023, Vol. 18 ›› Issue (3): 582-586.doi: 10.4103/1673-5374.350216

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脑代谢物N-乙酰天门冬氨酸水平与脊髓损伤痉挛患者感觉和运动功能障碍的关系

  

  • 出版日期:2023-03-15 发布日期:2022-08-27
  • 基金资助:

    国家自然科学基金项目(82071400,81870979);重大科学研究引导基金(No. 2020cz-01);首都卫生发展科研专项项目(2018-1-6011)

Association between brain N-acetylaspartate levels and sensory and motor dysfunction in patients who have spinal cord injury with spasticity: an observational case-control study

Jia-Yi Liu1, 2, 3, 4, 5, Ya-Jing Li6, Xin-Ying Cong7, Zuliyaer Talifu1, 2, 3, 4, 5, Xin Zhang1, 2, 3, 4, 5, Feng Gao1, 2, 3, 4, 5, *, Jian-Jun Li1, 2, 3, 4, 5, *   

  1. 1School of Rehabilitation, Capital Medical University, Beijing, China; 2Department of Spinal and Neural Function Reconstruction, China Rehabilitation Research Center, Beijing, China; 3China Rehabilitation Science Institute, Beijing, China; 4Beijing Key Laboratory of Neural Injury and Rehabilitation, Beijing, China; 5Center of Neural Injury and Repair, Beijing Institute for Brain Disorders, Beijing, China; 6Rehabilitation Department, Shanghai Huashan Hospital, Shanghai, China; 7Department of Medical Imaging, China Rehabilitation Research Center, Beijing, China
  • Online:2023-03-15 Published:2022-08-27
  • Contact: Jian-Jun Li, MD, crrclijj@163.com; Feng Gao, PhD, gaofeng5960@126.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, Nos. 82071400, 81870979, the Scientific Research Foundation of China Rehabilitation Research Center, No. 2020cz-01, and the Special Capital Health Research and Development of China, No. 2018-1-6011 (all to JJL).

摘要:

痉挛是脊髓损伤(SCI)后的一种严重并发症,但其维持和发展的病理生理机制仍然存在诸多未知。为确定脊髓损伤痉挛患者的左中央前回和基底神经节中代谢物的改变及其与临床状态之间的关系。试验共招募36名参与者进行磁共振波谱检查:23例脊髓损伤患者(12例有痉挛,11例无痉挛)和13名健康对照者。通过10mm3的体素获得中央前回和基底神经节的局部质子光谱。值得注意的是,单变量线性回归分析表明,随着中央前回中脊髓损伤患者神经元丢失标志物N-乙酰天门冬氨酸水平的降低,ASIA(美国脊髓损伤协会)的轻触觉评分、ASIA针刺觉评分以及ASIA运动评分均明显下降。此外,随着受伤时间的延长,中央前回中的N-乙酰天门冬氨酸水平也相应增加。有痉挛的脊髓损伤患者中央前回和基底神经节中的N-乙酰天门冬氨酸水平分别明显低于无痉挛患者。痉挛患者中央前回和基底神经节中的N-乙酰天门冬氨酸水平明显低于健康对照组。相较于脊髓损伤未痉挛患者,脊髓损伤痉挛患者N-乙酰天门冬氨酸水平下降与更为明显的感觉和运动功能障碍有关。

https://orcid.org/0000-0002-8441-7537 (Jian-Jun Li); https://orcid.org/0000-0002-9525-8324 (Feng Gao)

Abstract: Spinal cord injury is a severe and devastating disease, and spasticity is a common and severe complication that is notoriously refractory to treatment. However, the pathophysiological mechanisms underlying spasticity and its development remain largely unknown. The goal of the present study was to find differences, if any, in metabolites of the left precentral gyrus and basal ganglia of patients who have spinal cord injury with or without spasticity, and to explore the relationship between the brain metabolite concentrations and clinical status. Thirty-six participants were recruited for magnetic resonance spectroscopic examination: 23 with spinal cord injury (12 with spasticity and 11 without spasticity) and 13 healthy controls. We acquired localized proton spectra from the precentral gyrus and basal ganglia via 10 mm3 voxels. Notably, univariate linear regression analysis demonstrated that the lower that the N-acetylaspartate concentration (a marker for neuronal loss) was in the precentral gyrus of the patients, the lower their ASIA (American Spinal Injury Association) light-touch scores, pinprick scores, and motor scores. Additionally, longer durations of injury were associated with higher N-acetylaspartate levels in the precentral gyrus. Compared with the healthy participants and patients without spasticity, N-acetylaspartate levels in the patients with spasticity were significantly lower in both the precentral gyrus and basal ganglia. Lower N-acetylaspartate levels also correlated with greater sensory and motor dysfunction in the patients who had spinal cord injury with spasticity.

Key words: ASIA motor score, ASIA sensory score, basal ganglia, central nervous system, duration of injury, magnetic resonance spectroscopy, N-acetylaspartate, precentral gyrus, spasticity, spinal cord injury