Micro- and Macrostructural Changes in the Brain and Spinal Cord in Acute Spinal Cord Injury: A Multicenter qMRI Study

Motivation: To increase understanding of neurodegeneration processes during the acute stage after traumatic spinal cord injury (tSCI). Goal(s): To describe volumetric and microstructural alterations in the spinal cord and brain during the acute stage after tSCI across 8 European centers. Approach: Using Multiparameter Mapping, 58 tSCI and 64 healthy controls were analyzed. Voxel-based Morphometry and Voxel-based Quantification metrics were analyzed and correlated to clinical scores at 6-months post-injury. Results: tSCI patients showed higher iron-sensitive R2* and lower myelin-sensitive R1 values in the cervical cord. Lower R1 values were found in the sensorimotor-cortex and smaller R1 declines correlated with better patient mobility assessments at 6-months. Impact: By leveraging advanced Multiparameter Mapping MRI techniques across 8 European centers, we have identified specific volumetric and microstructural alterations that correlate with functional outcomes. These findings underscore the importance of early detection and targeted interventions, potentially guiding future therapeutic strategies.