Quantifying Spinal Cord and Brain Metabolic Alterations in the Motor System after Spinal Cord Injury Using Metabolite-Cycling Semi-Laser ¹H-MRS

Motivation: The metabolic changes in the motor system caused by spinal cord injury (SCI) in the lumbar enlargement are understudied. Goal(s): To non-invasively determine metabolic changes in chronic SCI across the motor system using a robust metabolite-cycling (MC) semi-LASER MRS sequence. Approach: 1H-MRS was optimized and applied in the lumbar cord enlargement and the leg area of the motor cortex in 16 SCI patients and 19 healthy controls using an optimized MC semi-LASER sequence. Results: SCI patients showed reduced total N-acetylaspartate in the atrophied lumbar cord and the motor cortex, indicative of neuronal changes (i.e., cell atrophy and/or loss). Impact: The feasibility of lumbar cord MRS has great potential to assess tissue integrity non-invasively and provide valuable insights into neurodegenerative processes, with the potential for developing new biomarkers to improve prognostication following SCI.