Neural Regeneration Research ›› 2023, Vol. 18 ›› Issue (3): 582-586.doi: 10.4103/1673-5374.350216

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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).

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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