Heterogeneity in microstructural deterioration following spinal cord injury

Journal article

Ghasem-Zadeh, Ali, Galea, Mary P., Nunn, Andrew, Panisset, Maya, Wang, Xiao-Fang, Iuliano, Sandra, Boyd, Steven K., Forwood, Mark R. and Seeman, Ego. (2021). Heterogeneity in microstructural deterioration following spinal cord injury. Bone. 142, p. 115778. https://doi.org/10.1016/j.bone.2020.115778

Publication dates
Authors	Ghasem-Zadeh, Ali, Galea, Mary P., Nunn, Andrew, Panisset, Maya, Wang, Xiao-Fang, Iuliano, Sandra, Boyd, Steven K., Forwood, Mark R. and Seeman, Ego
Abstract	Background Modelling and remodelling adapt bone morphology to accommodate strains commonly encountered during loading. If strains exceed a threshold threatening fracture, modelling-based bone formation increases bone volume reducing these strains. If unloading reduces strains below a threshold that inhibits resorption, increased remodelling-based bone resorption reduces bone volume restoring strains, but at the price of compromised bone volume and microstructure. As weight-bearing regions are adapted to greater strains, we hypothesized that microstructural deterioration will be more severe than at regions commonly adapted to low strains following spinal cord injury. Methods We quantified distal tibial, fibula and radius volumetric bone mineral density (vBMD) using high-resolution peripheral quantitative computed tomography in 31 men, mean age 43.5 years (range 23.5‐75.0), 12 with tetraplegia and 19 with paraplegia of 0.7 to 18.6 years duration, and 102 healthy age- and sex-matched controls. Differences in morphology relative to controls were expressed as standardized deviation (SD) scores (mean ± SD). Standardized between-region differences in vBMD were expressed as SDs (95% confidence intervals, CI). Results Relative to controls, men with tetraplegia had deficits in total vBMD of −1.72 ± 1.38 SD at the distal tibia (p < 0.001) and − 0.68 ± 0.69 SD at distal fibula (p = 0.041), but not at the distal radius, despite paralysis. Deficits in men with paraplegia were −2.14 ± 1.50 SD (p < 0.001) at the distal tibia and −0.83 ± 0.98 SD (p = 0.005) at the distal fibula while distal radial total vBMD was 0.23 ± 1.02 (p = 0.371), not significantly increased, despite upper limb mobility. Comparing regions, in men with tetraplegia, distal tibial total vBMD was 1.04 SD (95%CI 0.07, 2.01) lower than at the distal fibula (p = 0.037) and 1.51 SD (95%CI 0.45, 2.57) lower than at the distal radius (p = 0.007); the latter two sites did not differ from each other. Results were similar in men with paraplegia, but total vBMD at the distal fibula was 1.06 SD (95%CI 0.35, 1.77) lower than at the distal radius (p = 0.004). Conclusion Microarchitectural deterioration following spinal cord injury is heterogeneous, perhaps partly because strain thresholds regulating the cellular activity of mechano-transduction are region specific.
Keywords	cortical -bone; HR-pQCT; microstructure; paralysis; spinal -cord -injury; trabecular bone; unloading; weight-bearing
Year	2021
Journal	Bone
Journal citation	142, p. 115778
Publisher	Elsevier Inc.
ISSN	8756-3282
Digital Object Identifier (DOI)	https://doi.org/10.1016/j.bone.2020.115778
Scopus EID	2-s2.0-85097109139
Research or scholarly	Research
Page range	1-8
Publisher's version	License All rights reserved File Access Level Controlled
Output status	Published
Online	28 Nov 2020
Publication process dates
Accepted	25 Nov 2020
Deposited	26 Jul 2021

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Perilli, Egon, Bala, Yohann, Zebaze, Roger M., Reynolds, Karen J. and Seeman, Ego. (2015). Regional heterogeneity in the configuration of the intracortical canals of the femoral shaft. Calcified Tissue International. 97(4), pp. 327 - 335. https://doi.org/10.1007/s00223-015-0014-5

Changes in quality of life associated with fragility fractures : Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS)

Abimanyi-Ochom, J., Watts, Jennifer, Borgstrom, F., Nicholson, Geoffrey, Shore-Lorenti, Catherine, Stuart, Amanda, Zhang, Y., Luliano, S., Seeman, Ego, Prince, Richard, March, Lyn, Winzenberg, T., Laslett, Laura, Duque, Gustavo, Ebeling, P. and Sanders, K. M.. (2015). Changes in quality of life associated with fragility fractures : Australian arm of the International Cost and Utility Related to Osteoporotic Fractures Study (AusICUROS). Osteoporosis International. 26(6), pp. 1781 - 1790. https://doi.org/10.1007/s00198-015-3088-z

Genetic and environmental variances of bone microarchitecture and bone remodeling markers: A twin study

Bjornerem, Ashild, Bui, Q Minh, Wang, Xiaofang, Ghasem-Zadeh, Ali, Hopper, John L., Zebaze, Roger M. and Seeman, Ego. (2015). Genetic and environmental variances of bone microarchitecture and bone remodeling markers: A twin study. Journal of Bone and Mineral Research. 30(3), pp. 516 - 524. https://doi.org/10.1002/jbmr.2365

Bones material constituents and their contribution to bone strength in health, disease, and treatment

Bala, Y. and Seeman, Ego. (2015). Bones material constituents and their contribution to bone strength in health, disease, and treatment. Calcified Tissue International. 97(3), pp. 308 - 326. https://doi.org/10.1007/s00223-015-9971-y

A. Michael Parfitt: Enlightened scholar and revered mentor: May 10, 1930-May 18, 2015

Manolagas, Stavros C., Compston, Juliet, Rao, Sudhaker and Seeman, Ego. (2015). A. Michael Parfitt: Enlightened scholar and revered mentor: May 10, 1930-May 18, 2015. Journal of Bone and Mineral Research. 30(8), pp. 1349 - 1355. https://doi.org/10.1002/jbmr.2576

Co-administration of antiresorptive and anabolic agents: A missed opportunity

Seeman, Ego and Martin, T. John. (2015). Co-administration of antiresorptive and anabolic agents: A missed opportunity. Journal of Bone and Mineral Research. 30(5), pp. 753 - 764. https://doi.org/10.1002/jbmr.2496

The ABC of writing a grant proposal

Seeman, Ego. (2015). The ABC of writing a grant proposal. Osteoporosis International. 26(6), pp. 1665 - 1666. https://doi.org/10.1007/s00198-015-3085-2

Growth and age-related abnormalities in cortical structure and fracture risk

Seeman, Ego. (2015). Growth and age-related abnormalities in cortical structure and fracture risk. Endocrinology and Metabolism. 30(4), pp. 419 - 428. https://doi.org/10.3803/EnM.2015.30.4.419

High-resolution in vivo imaging of bone and joints: a window to microarchitecture

Geusens, P., Geusens, P., Chapurlat, Roland D., Chapurlat, Roland D., Schett, G., Ghasem-Zadeh, Ali, Ghasem-Zadeh, Ali, Seeman, Ego, De Jong, J. and Van Den Bergh, J.. (2014). High-resolution in vivo imaging of bone and joints: a window to microarchitecture. Nature Reviews Rheumatology. 10(5), pp. 304 - 313. https://doi.org/10.1038/nrrheum.2014.23

A new method of segmentation of compact-appearing, transitional and trabecular compartments and quantification of cortical porosity from high resolution peripheral quantitative computed tomographic images

Zebaze, Roger M., Ghasem-Zadeh, Ali, Mbala, A. and Seeman, Ego. (2013). A new method of segmentation of compact-appearing, transitional and trabecular compartments and quantification of cortical porosity from high resolution peripheral quantitative computed tomographic images. Bone. 54(1), pp. 8 - 20. https://doi.org/10.1016/j.bone.2013.01.007

Teriparatide improves bone quality and healing of atypical femoral fractures associated with bisphosphonate therapy

Chiang, Cherie Ying, Zebaze, Roger M.D., Ghasem-Zadeh, Ali, Iuliano-Burns, Sandra, Hardidge, Andrew and Seeman, Ego. (2013). Teriparatide improves bone quality and healing of atypical femoral fractures associated with bisphosphonate therapy. Bone. 52(1), pp. 360 - 365. https://doi.org/10.1016/j.bone.2012.10.006

Predictors of new and severe vertebral fractures: Results from the HoRIZoN Pivotal Fracture Trial

Wustrack, R., Seeman, Ego, Bucci-Rechtweg, C. and Burch, S.. (2012). Predictors of new and severe vertebral fractures: Results from the HoRIZoN Pivotal Fracture Trial. Osteoporosis International. 23(1), pp. 53 - 58. https://doi.org/10.1007/s00198-011-1664-4

The effect of acute exercise on undercarboxylated osteocalcin in obese men

Levinger, Itamar, Zebaze, Roger M., Jeru, G., Hare, David L., Selig, Steve and Seeman, Ego. (2011). The effect of acute exercise on undercarboxylated osteocalcin in obese men. Osteoporosis International. 22(5), pp. 1621 - 1626. https://doi.org/10.1007/s00198-010-1370-7