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Article: MRI mapping of hemodynamics in the human spinal cord.

Hemmerling, Kimberly J / Hoggarth, Mark A / Sandhu, Milap S / Parrish, Todd B / Bright, Molly G

bioRxiv : the preprint server for biology

2024

Abstract: Impaired spinal cord vascular function contributes to numerous neurological pathologies, making it important to be able to noninvasively characterize these changes. Here, we propose a functional magnetic resonance imaging (fMRI)-based method to map ... ...

Abstract	Impaired spinal cord vascular function contributes to numerous neurological pathologies, making it important to be able to noninvasively characterize these changes. Here, we propose a functional magnetic resonance imaging (fMRI)-based method to map spinal cord vascular reactivity (SCVR). We used a hypercapnic breath-holding task, monitored with end-tidal CO
Language	English
Publishing date	2024-02-27
Publishing country	United States
Document type	Preprint
DOI	10.1101/2024.02.22.581606
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Article ; Online: Spatial distribution of hand-grasp motor task activity in spinal cord functional magnetic resonance imaging.

Hemmerling, Kimberly J / Hoggarth, Mark A / Sandhu, Milap S / Parrish, Todd B / Bright, Molly G

Human brain mapping

2023 Volume 44, Issue 17, Page(s) 5567–5581

Abstract: Upper extremity motor paradigms during spinal cord functional magnetic resonance imaging (fMRI) can provide insight into the functional organization of the cord. Hand-grasping is an important daily function with clinical significance, but previous ... ...

Abstract	Upper extremity motor paradigms during spinal cord functional magnetic resonance imaging (fMRI) can provide insight into the functional organization of the cord. Hand-grasping is an important daily function with clinical significance, but previous studies of similar squeezing movements have not reported consistent areas of activity and are limited by sample size and simplistic analysis methods. Here, we study spinal cord fMRI activation using a unimanual isometric hand-grasping task that is calibrated to participant maximum voluntary contraction (MVC). Two task modeling methods were considered: (1) a task regressor derived from an idealized block design (Ideal) and (2) a task regressor based on the recorded force trace normalized to individual MVC (%MVC). Across these two methods, group motor activity was highly lateralized to the hemicord ipsilateral to the side of the task. Activation spanned C5-C8 and was primarily localized to the C7 spinal cord segment. Specific differences in spatial distribution are also observed, such as an increase in C8 and dorsal cord activity when using the %MVC regressor. Furthermore, we explored the impact of data quantity and spatial smoothing on sensitivity to hand-grasp motor task activation. This analysis shows a large increase in number of active voxels associated with the number of fMRI runs, sample size, and spatial smoothing, demonstrating the impact of experimental design choices on motor activation.
MeSH term(s)	Humans ; Motor Activity/physiology ; Spinal Cord/diagnostic imaging ; Magnetic Resonance Imaging/methods ; Upper Extremity/physiology ; Hand Strength
Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1197207-5
ISSN	1097-0193 ; 1065-9471
ISSN (online)	1097-0193
ISSN	1065-9471
DOI	10.1002/hbm.26458
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Article: Spatial distribution of hand-grasp motor task activity in spinal cord functional magnetic resonance imaging.

Hemmerling, Kimberly J / Hoggarth, Mark A / Sandhu, Milap S / Parrish, Todd B / Bright, Molly G

bioRxiv : the preprint server for biology

2023

Abstract	Upper extremity motor paradigms during spinal cord functional magnetic resonance imaging (fMRI) can provide insight into the functional organization of the cord. Hand-grasping is an important daily function with clinical significance, but previous studies of similar squeezing movements have not reported consistent areas of activity and are limited by sample size and simplistic analysis methods. Here, we study spinal cord fMRI activation using a unimanual isometric hand-grasping task that is calibrated to participant maximum voluntary contraction (MVC). Two task modeling methods were considered: (1) a task regressor derived from an idealized block design (Ideal) and (2) a task regressor based on the recorded force trace normalized to individual MVC (%MVC). Across these two methods, group motor activity was highly lateralized to the hemicord ipsilateral to the side of the task. Activation spanned C5-C8 and was primarily localized to the C7 spinal cord segment. Specific differences in spatial distribution are also observed, such as an increase in C8 and dorsal cord activity when using the %MVC regressor. Furthermore, we explored the impact of data quantity and spatial smoothing on sensitivity to hand-grasp motor task activation. This analysis shows a large increase in number of active voxels associated with the number of fMRI runs, sample size, and spatial smoothing, demonstrating the impact of experimental design choices on motor activation.
Language	English
Publishing date	2023-07-19
Publishing country	United States
Document type	Preprint
DOI	10.1101/2023.04.25.537883
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Article: Effects of variability in manually contoured spinal cord masks on fMRI co-registration and interpretation.

Hoggarth, Mark A / Wang, Max C / Hemmerling, Kimberly J / Vigotsky, Andrew D / Smith, Zachary A / Parrish, Todd B / Weber, Kenneth A / Bright, Molly G

Frontiers in neurology

2022 Volume 13, Page(s) 907581

Abstract: Functional magnetic resonance imaging (fMRI) of the human spinal cord (SC) is a unique non-invasive method for characterizing neurovascular responses to stimuli. Group-analysis of SC fMRI data involves co-registration of subject-level data to standard ... ...

Abstract	Functional magnetic resonance imaging (fMRI) of the human spinal cord (SC) is a unique non-invasive method for characterizing neurovascular responses to stimuli. Group-analysis of SC fMRI data involves co-registration of subject-level data to standard space, which requires manual masking of the cord and may result in bias of group-level SC fMRI results. To test this, we examined variability in SC masks drawn in fMRI data from 21 healthy participants from a completed study mapping responses to sensory stimuli of the C7 dermatome. Masks were drawn on temporal mean functional image by eight raters with varying levels of neuroimaging experience, and the rater from the original study acted as a reference. Spatial agreement between rater and reference masks was measured using the Dice Similarity Coefficient, and the influence of rater and dataset was examined using ANOVA. Each rater's masks were used to register functional data to the PAM50 template. Gray matter-white matter signal contrast of registered functional data was used to evaluate the spatial normalization accuracy across raters. Subject- and group-level analyses of activation during left- and right-sided sensory stimuli were performed for each rater's co-registered data. Agreement with the reference SC mask was associated with both rater (F
Language	English
Publishing date	2022-10-20
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564214-5
ISSN	1664-2295
ISSN	1664-2295
DOI	10.3389/fneur.2022.907581
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Article ; Online: Trunk Muscle Characteristics: Differences Between Sedentary Adults With and Without Unilateral Lower Limb Amputation.

Sions, Jaclyn M / Beisheim, Emma H / Hoggarth, Mark A / Elliott, James M / Hicks, Gregory E / Pohlig, Ryan T / Seth, Mayank

Archives of physical medicine and rehabilitation

2021 Volume 102, Issue 7, Page(s) 1331–1339

Abstract: Objective: The primary purpose of this study was to compare trunk muscle characteristics between adults with and without unilateral lower limb amputation (LLA) to determine the presence of modifiable trunk muscle deficits (ie, impaired activity, reduced ...

Abstract	Objective: The primary purpose of this study was to compare trunk muscle characteristics between adults with and without unilateral lower limb amputation (LLA) to determine the presence of modifiable trunk muscle deficits (ie, impaired activity, reduced volume, increased intramuscular fat) evaluated by ultrasonography (US) and magnetic resonance imaging (MRI). We hypothesized that compared with adults without LLA (controls), individuals with transfemoral or transtibial LLA would demonstrate reduced multifidi activity, worse multifidi and erector spinae morphology, and greater side-to-side trunk muscle asymmetries. Design: Cross-sectional imaging study. Setting: Research laboratory and imaging center. Participants: Sedentary adults (n=38 total) with LLA (n=9 transfemoral level; n=14 transtibial level) and controls without LLA (n=15). Interventions: Not applicable. Main outcome measures: We examined bilateral multifidi activity using US at levels L3/L4-L5/S1. MRI was performed using 3-dimensional quantitative fat-water imaging; bilateral L1-L5 multifidi and erector spinae were manually traced, and muscle volume (normalized to body weight) and percentage intramuscular fat were determined. Between-group and side-to-side differences were evaluated. Results: Compared with adults without LLA, participants with LLA demonstrated reduced sound-side multifidi activity; those with transfemoral LLA had larger amputated-side multifidi volume, whereas those with transtibial LLA had greater sound- and amputated-side erector spinae intramuscular fat (P<.050). With transfemoral LLA, side-to-side differences in erector spinae volume, as well as multifidi and erector spinae intramuscular fat, were found (P<.050). Conclusions: Impaired trunk muscle activity and increased intramuscular fat may be modifiable targets for intervention after LLA.
MeSH term(s)	Adult ; Amputees ; Back Muscles/diagnostic imaging ; Back Muscles/physiopathology ; Cross-Sectional Studies ; Female ; Humans ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Sedentary Behavior ; Torso/diagnostic imaging ; Torso/physiopathology ; Ultrasonography
Language	English
Publishing date	2021-03-05
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2021.02.008
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Article ; Online: Macromolecular changes in spinal cord white matter characterize whiplash outcome at 1-year post motor vehicle collision.

Hoggarth, Mark A / Elliott, James M / Smith, Zachary A / Paliwal, Monica / Kwasny, Mary J / Wasielewski, Marie / Weber, Kenneth A / Parrish, Todd B

Scientific reports

2020 Volume 10, Issue 1, Page(s) 22221

Abstract: Each year, whiplash injuries from motor vehicle collisions (MVC) affect millions worldwide, with no strong evidence of pathology. While the majority recover soon after the injury, the same is not true for roughly 20% reporting higher levels of pain and ... ...

Abstract	Each year, whiplash injuries from motor vehicle collisions (MVC) affect millions worldwide, with no strong evidence of pathology. While the majority recover soon after the injury, the same is not true for roughly 20% reporting higher levels of pain and distress, without diagnostic options. This study used magnetization transfer (MT) imaging to quantify white matter integrity in 78 subjects with varying levels of pain, 1 year after MVC. MT images of the cervical spinal cord were collected parallel to the intervertebral disks. MT ratios (MTR) were calculated in select white matter tracts along with MTR homogeneity (MTRh) at each level. Significant differences were observed between clinical outcome groups in the left and right spinothalamic tracts (p = 0.003 and 0.020) and MTRh (p = 0.009). MTRh was elevated in females with poor recovery versus females reporting recovery (p < 0.001) or milder symptoms (p < 0.001), and in males reporting recovery (p = 0.007) or no recovery (p < 0.001). There was a significant interaction between recovery status and sex (p = 0.015). MT imaging identified tract specific and regional changes in white matter integrity suggesting potential insults to the cord. Additionally, significant MTRh differences between sexes were observed, characterizing the heterogeneity of whiplash recovery and worse outcomes in females.
MeSH term(s)	Adult ; Analysis of Variance ; Biomarkers ; Female ; Humans ; Image Processing, Computer-Assisted ; Magnetic Resonance Imaging ; Male ; Spinal Cord/diagnostic imaging ; Spinal Cord/metabolism ; Spinal Cord/pathology ; Spinal Cord Injuries/etiology ; Spinal Cord Injuries/metabolism ; Spinal Cord Injuries/pathology ; Time Factors ; White Matter/diagnostic imaging ; White Matter/metabolism ; White Matter/pathology
Chemical Substances	Biomarkers
Language	English
Publishing date	2020-12-17
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-79190-5
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Article ; Online: Confirming the geography of fatty infiltration in the deep cervical extensor muscles in whiplash recovery.

Smith, Andrew C / Albin, Stephanie R / Abbott, Rebecca / Crawford, Rebecca J / Hoggarth, Mark A / Wasielewski, Marie / Elliott, James M

Scientific reports

2020 Volume 10, Issue 1, Page(s) 11471

Abstract: Previous preliminary work mapped the distribution of neck muscle fat infiltration (MFI) in the deep cervical extensor muscles (multifidus and semispinalis cervicis) in a small cohort of participants with chronic whiplash associated disorders (WAD), ... ...

Abstract	Previous preliminary work mapped the distribution of neck muscle fat infiltration (MFI) in the deep cervical extensor muscles (multifidus and semispinalis cervicis) in a small cohort of participants with chronic whiplash associated disorders (WAD), recovered, and healthy controls. While MFI was reported to be concentrated in the medial portion of the muscles in all participants, the magnitude was significantly greater in those with chronic WAD. This study aims to confirm these results in a prospective fashion with a larger cohort and compare the findings across a population of patients with varying levels of WAD-related disability one-year following the motor vehicle collision. Sixty-one participants enrolled in a longitudinal study: Recovered (n = 25), Mild (n = 26) and Severe WAD (n = 10) were studied using Fat/Water magnetic resonance imaging, 12-months post injury. Bilateral measures of MFI in four quartiles (Q1-Q4; medial to lateral) at cervical levels C4 through C7 were included. A linear mixed model was performed, controlling for covariates (age, sex, body mass index), examining interaction effects, and comparing MFI distribution between groups. The recovered group had significantly less MFI in Q1 compared to the two symptomatic groups. Group differences were not found in the more lateral quartiles. Results at 12 months are consistent with the preliminary study, indicating that MFI is spatially concentrated in the medial portions of the deep cervical extensors regardless of WAD recovery, but the magnitude of MFI in the medial portions of the muscles is significantly larger in those with severe chronic WAD.
MeSH term(s)	Adipose Tissue/diagnostic imaging ; Adipose Tissue/pathology ; Adolescent ; Adult ; Aged ; Cervical Vertebrae/diagnostic imaging ; Cervical Vertebrae/metabolism ; Cervical Vertebrae/pathology ; Disabled Persons/rehabilitation ; Female ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Neck/diagnostic imaging ; Neck/pathology ; Neck Muscles/diagnostic imaging ; Neck Muscles/pathology ; Paraspinal Muscles/diagnostic imaging ; Paraspinal Muscles/pathology ; Prospective Studies ; Whiplash Injuries/diagnostic imaging ; Whiplash Injuries/pathology ; Whiplash Injuries/therapy ; Young Adult
Language	English
Publishing date	2020-07-10
Publishing country	England
Document type	Clinical Trial ; Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-020-68452-x
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Article: The Effects of Reconditioning Exercises Following Prolonged Bed Rest on Lumbopelvic Muscle Volume and Accumulation of Paraspinal Muscle Fat.

De Martino, Enrico / Hides, Julie / Elliott, James M / Hoggarth, Mark A / Zange, Jochen / Lindsay, Kirsty / Debuse, Dorothée / Winnard, Andrew / Beard, David / Cook, Jonathan A / Salomoni, Sauro E / Weber, Tobias / Scott, Jonathan / Hodges, Paul W / Caplan, Nick

Frontiers in physiology

2022 Volume 13, Page(s) 862793

Abstract: Reduced muscle size and accumulation of paraspinal muscle fat content (PFC) have been reported in lumbopelvic muscles after spaceflights and head-down tilt (HDT) bed rest. While some information is available regarding reconditioning programs on muscle ... ...

Abstract	Reduced muscle size and accumulation of paraspinal muscle fat content (PFC) have been reported in lumbopelvic muscles after spaceflights and head-down tilt (HDT) bed rest. While some information is available regarding reconditioning programs on muscle atrophy recovery, the effects on the accumulation of PFC are unknown. Recently, a device (the Functional Re-adaptive Exercise Device-FRED) has been developed which aims to specifically recruit lumbopelvic muscles. This study aimed to investigate the effects of a standard reconditioning (SR) program and SR program supplemented by FRED (SR + FRED) on the recovery of the lumbopelvic muscles following 60-day HDT bed rest. Twenty-four healthy participants arrived at the facility for baseline data collection (BDC) before the bed rest period. They remained in the facility for 13-day post-HDT bed rest and were randomly allocated to one of two reconditioning programs: SR or SR + FRED. Muscle volumes of the lumbar multifidus (LM), lumbar erector spinae (LES), quadratus lumborum (QL), and psoas major (PM) muscles were measured from axial T1-weighted magnetic resonance imaging (MRI) at all lumbar intervertebral disc levels. PFC was determined using a chemical shift-based lipid/water Dixon sequence. Each lumbopelvic muscle was segmented into four equal quartiles (from medial to lateral). MRI of the lumbopelvic region was conducted at BDC, Day-59 of bed rest (HDT59), and Day-13 after reconditioning (R13). Comparing R13 with BDC, the volumes of the LM muscle at L4/L5 and L5/S1, LES at L1/L2, and QL at L3/L4 had not recovered (all-
Language	English
Publishing date	2022-06-14
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564217-0
ISSN	1664-042X
ISSN	1664-042X
DOI	10.3389/fphys.2022.862793
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Article ; Online: New insights into intrinsic foot muscle morphology and composition using ultra-high-field (7-Tesla) magnetic resonance imaging.

Franettovich Smith, Melinda M / Elliott, James M / Al-Najjar, Aiman / Weber, Kenneth A / Hoggarth, Mark A / Vicenzino, Bill / Hodges, Paul W / Collins, Natalie J

BMC musculoskeletal disorders

2021 Volume 22, Issue 1, Page(s) 97

Abstract: Background: The intrinsic muscles of the foot are key contributors to foot function and are important to evaluate in lower limb disorders. Magnetic resonance imaging (MRI), provides a non-invasive option to measure muscle morphology and composition, ... ...

Abstract	Background: The intrinsic muscles of the foot are key contributors to foot function and are important to evaluate in lower limb disorders. Magnetic resonance imaging (MRI), provides a non-invasive option to measure muscle morphology and composition, which are primary determinants of muscle function. Ultra-high-field (7-T) magnetic resonance imaging provides sufficient signal to evaluate the morphology of the intrinsic foot muscles, and, when combined with chemical-shift sequences, measures of muscle composition can be obtained. Here we aim to provide a proof-of-concept method for measuring intrinsic foot muscle morphology and composition with high-field MRI. Methods: One healthy female (age 39 years, mass 65 kg, height 1.73 m) underwent MRI. A T1-weighted VIBE - radio-frequency spoiled 3D steady state GRE - sequence of the whole foot was acquired on a Siemens 7T MAGNETOM scanner, as well as a 3T MAGNETOM Prisma scanner for comparison. A high-resolution fat/water separation image was also acquired using a 3D 2-point DIXON sequence at 7T. Coronal plane images from 3T and 7T scanners were compared. Using 3D Slicer software, regions of interest were manually contoured for each muscle on 7T images. Muscle volumes and percentage of muscle fat infiltration were calculated (muscle fat infiltration % = Fat/(Fat + Water) x100) for each muscle. Results: Compared to the 3T images, the 7T images provided superior resolution, particularly at the forefoot, to facilitate segmentation of individual muscles. Muscle volumes ranged from 1.5 cm Conclusions: This proof-of-concept study demonstrates a feasible method of quantifying muscle morphology and composition for individual intrinsic foot muscles using advanced high-field MRI techniques. This method can be used in future studies to better understand intrinsic foot muscle morphology and composition in healthy individuals, as well as those with lower disorders.
MeSH term(s)	Adult ; Female ; Foot/diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Muscle, Skeletal/diagnostic imaging ; Software
Language	English
Publishing date	2021-01-21
Publishing country	England
Document type	Journal Article
ISSN	1471-2474
ISSN (online)	1471-2474
DOI	10.1186/s12891-020-03926-7
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Article ; Online: Geography of Lumbar Paravertebral Muscle Fatty Infiltration: The Influence of Demographics, Low Back Pain, and Disability.

Crawford, Rebecca J / Volken, Thomas / Ni Mhuiris, Áine / Bow, Cora C / Elliott, James M / Hoggarth, Mark A / Samartzis, Dino

Spine

2019 Volume 44, Issue 18, Page(s) 1294–1302

Abstract: Study design: Cross-sectional.: Objective: We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns.: Summary of background data: ... ...

Abstract	Study design: Cross-sectional. Objective: We quantified fatty infiltration (FI) geography of the lumbar spine to identify whether demographics, temporal low back pain (LBP), and disability influence FI patterns. Summary of background data: Lumbar paravertebral muscle FI has been associated with age, sex, LBP, and disability; yet, FI accumulation patterns are inadequately described to optimize interventions. Methods: This cross-sectional study employed lumbar axial T1-weighted magnetic resonance imaging in 107 Southern-Chinese adults (54 females, 53 males). Single-slices at the vertebral inferior end-plate per lumbar level were measured for quartiled-FI, and analyzed against demographics, LBP, and disability (Oswestry Disability Index). Results: Mean FI% was higher in females, on the right, increased per level caudally, and from medial to lateral in men (P < 0.05). FI linearly increased with age for both sexes (P < 0.01) and was notably higher at L 4&5 than L1, 2&3 for cases aged 40 to 65 years. BMI and FI were unrelated in females and inversely in males (P < 0.001). Females with LBPweek and males with LBPyear had 1.7% (each) less average FI (P < 0.05) than those without pain at that time-point. Men locating their LBP in the back had less FI than those without pain (P < 0.001). Disability was unrelated to FI for both sexes (P > 0.05). Conclusion: Lumbar paravertebral muscle FI predominates in the lower lumbar spine, notably for those aged 40 to 65, and depends more on sagittal than transverse distribution. Higher FI in females and differences of mean FI between sexes for BMI, LBP, and disabling Oswestry Disability Index suggest sex-differential accumulation patterns. Our study contradicts pain models rationalizing lumbar muscle FI and may reflect a normative sex-dependent feature of the natural history of lumbar paravertebral muscles. Level of evidence: 2.
MeSH term(s)	Adult ; Aged ; Cross-Sectional Studies ; Demography ; Disabled Persons ; Female ; Humans ; Low Back Pain ; Lumbar Vertebrae/anatomy & histology ; Lumbar Vertebrae/diagnostic imaging ; Lumbosacral Region/anatomy & histology ; Lumbosacral Region/diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Young Adult
Language	English
Publishing date	2019-03-29
Publishing country	United States
Document type	Journal Article
ZDB-ID	752024-4
ISSN	1528-1159 ; 0362-2436
ISSN (online)	1528-1159
ISSN	0362-2436
DOI	10.1097/BRS.0000000000003060
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