Temporal Dynamics of Cerebral Myo-Inositol Detected by Magnetic Resonance Spectroscopy Reflect Astrocyte Plasticity Following Spinal Cord Injury: A Prospective Observational Study
Abstract
Abstract Objectives The present study aimed to characterise the temporal pattern of cerebral MI alterations in SCI participants and to relate these findings to the biphasic behaviour of reactive astrocytes. Methods Twenty-nine participants were enrolled: 17 participants with traumatic SCI and paraplegia (9 within ≤ 6 months of injury onset [acute–subacute group] and 8 beyond 6 months of injury onset [chronic group]) and 12 healthy controls. Single-voxel proton MRS was performed on a 3 T MRI scanner (TR/TE = 2000/144 ms; voxel size 10 cm³) with the region of interest positioned over the left anterior central gyrus. Absolute concentrations of MI, N-acetyl aspartate (NAA), total choline (Cho), and total creatine (Cr) were quantified. Between-group comparisons were performed using independent-samples t-tests or the Mann–Whitney U test as appropriate, with Pearson or Spearman correlation analyses to assess metabolite–clinical correlations. Results MI concentration was significantly higher in all SCI participants compared with healthy controls (0.016 ± 0.008 vs. 0.009 ± 0.005 nmol; P = 0.014). The acute–subacute group demonstrated the greatest MI elevation relative to both healthy controls (0.021 ± 0.007 nmol; P = 0.001) and the chronic group (0.011 ± 0.004 nmol; P = 0.006). Notably, MI concentration in the chronic group did not differ significantly from healthy controls (P = 0.311), indicating progressive normalisation of cortical MI over time. No significant differences in NAA,…
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