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Visibility graph analysis of intraspinal pressure signal predicts functional outcome in spinal cord injured patients.

Chen, S; Gallagher, MJ; Hogg, F; Papadopoulos, MC; Saadoun, S (2018) Visibility graph analysis of intraspinal pressure signal predicts functional outcome in spinal cord injured patients. J Neurotrauma, 35 (24). pp. 2947-2956. ISSN 1557-9042 https://doi.org/10.1089/neu.2018.5775
SGUL Authors: Papadopoulos, Marios Saadoun, Samira Hogg, Florence Rosie Avila Chen, Su Liang Gallagher, Mathew Joseph

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Abstract

To guide management of patients with acute spinal cord injuries, we developed intraspinal pressure monitoring from the injury site. Here, we examine the complex fluctuations in the intraspinal pressure signal using network theory. We analyzed 7,097 hours of intraspinal pressure data from 58 patients with severe cord injuries. Intraspinal pressure signals were split into hourly windows. Each window was mapped into a visibility graph as follows: Vertical bars were drawn at 0.1 Hz representing signal amplitudes. Each bar produced a node, thus totalling 360 nodes per graph. Two nodes were linked with an edge if the straight line through the nodes did not intersect a bar. We computed several topological metrics for each graph including diameter, modularity, eccentricity and small-worldness. Patients were followed up for 20 months on average. Our data show that the topological structure of intraspinal pressure visibility graphs is highly sensitive to pathological events at the injury site including cord compression (high intraspinal pressure), ischemia (low spinal cord perfusion pressure) and deranged autoregulation (high spinal pressure reactivity index). These pathological changes correlate with long graph diameter, high modularity, high eccentricity and reduced small-worldness. In a multivariate logistic regression model, age, neurological status on admission and average node eccentricity were independent predictors of neurological improvement. We conclude that analysis of intraspinal pressure fluctuations after spinal cord injury as graphs, rather than time series, captures clinically important information. Our novel technique may be applied to other signals recorded from injured CNS e.g intracranial pressure, tissue metabolite and oxygen levels.

Item Type: Article
Additional Information: Final publication is available from Mary Ann Liebert, Inc., publishers http://dx.doi.org/10.1089/neu.2018.5775
Keywords: CLINICAL MANAGEMENT OF CNS INJURY, HUMAN STUDIES, INTRACRANIAL PRESSURE, SECONDARY INSULT, spinal cord injury, Neurology & Neurosurgery, 1103 Clinical Sciences, 1109 Neurosciences
SGUL Research Institute / Research Centre: Academic Structure > Molecular and Clinical Sciences Research Institute (MCS)
Journal or Publication Title: J Neurotrauma
ISSN: 1557-9042
Language: eng
Dates:
DateEvent
13 December 2018Published
13 August 2018Published Online
Publisher License: Publisher's own licence
Projects:
Project IDFunderFunder ID
UNSPECIFIEDWings for Life Spinal Cord Research FoundationUNSPECIFIED
UNSPECIFIEDFletcher FundUNSPECIFIED
UNSPECIFIEDNeurosciences Research Foundationhttp://dx.doi.org/10.13039/100007431
UNSPECIFIEDLondon Deaneryhttp://dx.doi.org/10.13039/501100001289
PubMed ID: 30101641
Go to PubMed abstract
URI: https://openaccess.sgul.ac.uk/id/eprint/110062
Publisher's version: https://doi.org/10.1089/neu.2018.5775

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