Selective Vulnerability of White Matter during Spinal Cord Ischemia

The long-term effects of spinal cord ischemia were studied in 21 rats by lesion scores (LS, n = 21), somatosensory evoked potentials (SEP, n = 16), electromyographic measurements (EMG, n = 12) and histology of the spinal cord ( n = 21) 48.5 ± 57.2 days after 10- to 12-min occlusion of the thoracic aorta and subclavian arteries. All the animals were initially paraplegic with a spastic presentation but seven recovered within 2 days (group A), demonstrating low LS (3.4 ± 1.05) normal EMGs ( n = 3) and unremarkable histology. The 14 paraplegic animals presented relevant findings of the lumbar cord consisting of white matter lesions only (group B, n = 7) or white and gray matter lesions (group C, n = 7). Group B animals showed severe deficit (LS = 11.8 ± 2.93) without denervation on EMG ( n = 5) or muscle atrophy on histology. Group C animals displayed equal impairment (LS = 14.4 ± 0.71), denervation on EMG ( n = 4), and muscle atrophy. Resting motor unit activity of groups B and C were significantly different from group A ( p < 0.001), while LS of groups B and C did not differ ( p = 0.083). These data underscore the nature and the extent of white matter lesions during spinal cord ischemia, a finding which has generally been eclipsed by emphasis on gray matter lesions in previous studies.