Spinal cord atrophy after spinal cord injury – A systematic review and meta-analysis

IF 3.6 2区医学 Q2 NEUROIMAGING Neuroimage-Clinical Pub Date : 2023-01-01 DOI:10.1016/j.nicl.2023.103372

Carl Trolle , Estee Goldberg , Clas Linnman

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引用次数: 1

Abstract

Cervical spinal cord atrophy occurs after spinal cord injury. The atrophy and how level of injury affects atrophy differs between studies. A systematic review and metaanalysis were done after systematic searches of PubMed, CINAHL, APA PsycInfo and Web of Science. English language original studies analyzing MRI cervical spinal cord cross-sectional area in adults with spinal cord injury were included. Atrophy and correlation between injury level and atrophy were estimated with random-effects models, standardized mean differences, and 95% confidence intervals. 24 studies were identified. 13/24 studies had low risk of bias. Cord atrophy meta-analysis of 18 articles corresponded to a standardized mean difference of -1.48 (95% CI -1.78 to -1.19) with moderate to large interstudy heterogeneity. Logarithmic time since injury influenced heterogeneity. Longitudinal atrophy was best described by a logarithmic model, indicating that rate of spinal atrophy decreases over time. Meta-correlation of eight studies indicated more severe atrophy in more rostral injuries (0.41, 95% CI 0.20-0.59). Larger and preferably longitudinal studies, data sharing, and standardized protocols are warranted.

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脊髓损伤后脊髓萎缩-系统回顾和荟萃分析

脊髓损伤后发生颈脊髓萎缩。不同研究的萎缩和损伤程度对萎缩的影响不同。在系统检索PubMed、CINAHL、APA PsycInfo和Web of Science后，进行了系统综述和荟萃分析。包括分析成人脊髓损伤的MRI颈脊髓横截面积的英文原始研究。用随机效应模型、标准化平均差和95%置信区间估计萎缩以及损伤程度和萎缩之间的相关性。确定了24项研究。13/24项研究的偏倚风险较低。对18篇文章进行的脊髓萎缩荟萃分析显示，标准化平均差为-1.48（95%CI-1.78至-1.19），具有中度至重度研究间异质性。受伤后的对数时间影响异质性。纵向萎缩最好用对数模型来描述，这表明脊髓萎缩的发生率随着时间的推移而降低。八项研究的Meta相关性表明，更多的口腔损伤会导致更严重的萎缩（0.41，95%CI 0.20-0.59）。有必要进行更大规模的纵向研究、数据共享和标准化方案。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neuroimage-Clinical NEUROIMAGING-

CiteScore

7.50

自引率

4.80%

发文量

368

审稿时长

52 days

期刊介绍： NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.