Traumatic spinal cord injury – transition from a focal lesion to widespread neurodegeneration: Lessons from 60-month observational data

Traumatic spinal cord injury (SCI) triggers a cascade of neurodegenerative events across the neuroaxis. The trajectories of lesion characteristics and brain and spinal cord macro-and microstructural changes were analysed over five years in 23 SCI patients and 21 healthy controls. Initially, SCI patients showed higher volume and iron content in the spinal cord which decreased over time. They showed lower myelin-sensitive MTsat values in the dorsal column and cortex which also decreased over time and were associated with acute lesion characteristics. These observations illustrate the widespread and progressive neuroplastic processes after SCI, its magnitude being predicted by acute lesion characteristics.