Dataset Information

Functional Preservation and Reorganization of Brain during Motor Imagery in Patients with Incomplete Spinal Cord Injury: A Pilot fMRI Study.

ABSTRACT: Motor imagery (MI) is a cognitive process involved in mentally rehearsing movement representations, and it has great potential for the rehabilitation of motor function in patients with spinal cord injuries. The aim of this study was to explore changes in the brain activation patterns in incomplete spinal cord injury (ISCI) patients during motor execution (ME) and MI tasks, and to thereby explore whether MI shares similar motor-related networks with ME in ISCI patients. Seventeen right-handed ISCI patients with impaired motor function of their right ankles and 17 age- and gender-matched healthy controls were enrolled in this study. The activation patterns of the ISCI subjects and those of the healthy subjects were compared, both during mental dorsi-plantar flexion of the right ankle (the MI task) and the actual movement of the joint (the ME task). The patients and the healthy controls shared similar activation patterns during the MI or ME tasks. The activation patterns of the MI task between the patients and the healthy controls were more similar than those of the ME task. These findings indicate that the MI network is more functionally preserved than the ME network in ISCI patients. In addition, increased activation in the motor-related regions during ME task, and decreased activation in the parietal regions during both ME and MI tasks, were identified in the ISCI patients compared to the healthy controls, indicating a functional reorganization of these regions after ISCI. The functional preservation and reorganization of the MI network in the ISCI patients suggests a potential role for MI training in motor rehabilitation.

SUBMITTER: Chen X

PROVIDER: S-EPMC4753296 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

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Functional Preservation and Reorganization of Brain during Motor Imagery in Patients with Incomplete Spinal Cord Injury: A Pilot fMRI Study.

Chen Xin X Wan Lu L Qin Wen W Zheng Weimin W Qi Zhigang Z Chen Nan N Li Kuncheng K

Frontiers in human neuroscience 20160215

Motor imagery (MI) is a cognitive process involved in mentally rehearsing movement representations, and it has great potential for the rehabilitation of motor function in patients with spinal cord injuries. The aim of this study was to explore changes in the brain activation patterns in incomplete spinal cord injury (ISCI) patients during motor execution (ME) and MI tasks, and to thereby explore whether MI shares similar motor-related networks with ME in ISCI patients. Seventeen right-handed ISC ...[more]

PMID: 26913000

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Project description:Deficient ankle control after incomplete spinal cord injury (iSCI) often accentuates walking impairments. Transcutaneous electrical spinal cord stimulation (tSCS) has been shown to augment locomotor activity after iSCI, presumably due to modulation of spinal excitability. However, the effects of possible excitability modulations induced by tSCS on ankle control have not yet been assessed. This study investigated the immediate (i.e., without training) effects during single-sessions of tonic tSCS on ankle control, spinal excitability, and locomotion in ten individuals with chronic, sensorimotor iSCI (American Spinal Injury Association Impairment Scale D). Participants performed rhythmic ankle movements (dorsi- and plantar flexion) at a given rate, and irregular ankle movements following a predetermined trajectory with and without tonic tSCS at 15 Hz, 30 Hz, and 50 Hz. In a subgroup of eight participants, the effects of tSCS on assisted over-ground walking were studied. Furthermore, the activity of a polysynaptic spinal reflex, associated with spinal locomotor networks, was investigated to study the effect of the stimulation on the dedicated spinal circuitry associated with locomotor function. Tonic tSCS at 30 Hz immediately improved maximum dorsiflexion by +4.6° ± 0.9° in the more affected lower limb during the rhythmic ankle movement task, resulting in an increase of +2.9° ± 0.9° in active range of motion. Coordination of ankle movements, assessed by the ability to perform rhythmic ankle movements at a given target rate and to perform irregular movements according to a trajectory, was unchanged during stimulation. tSCS at 30 Hz modulated spinal reflex activity, reflected by a significant suppression of pathological activity specific to SCI in the assessed polysynaptic spinal reflex. During walking, there was no statistical group effect of tSCS. In the subgroup of eight assessed participants, the three with the lowest as well as the one with the highest walking function scores showed positive stimulation effects, including increased maximum walking speed, or more continuous and faster stepping at a self-selected speed. Future studies need to investigate if multiple applications and individual optimization of the stimulation parameters can increase the effects of tSCS, and if the technique can improve the outcome of locomotor rehabilitation after iSCI.

Project description:The impact of traumatic spinal cord injury on structural integrity, cortical reorganization and ensuing disability is variable and may depend on a dynamic interaction between the severity of local damage and the capacity of the brain for plastic reorganization. We investigated trauma-induced anatomical changes in the spinal cord and brain, and explored their relationship to functional changes in sensorimotor cortex. Structural changes were assessed using cross-sectional cord area, voxel-based morphometry and voxel-based cortical thickness of T1-weighted images in 10 subjects with cervical spinal cord injury and 16 controls. Cortical activation in response to right-sided (i) handgrip; and (ii) median and tibial nerve stimulation were assessed using functional magnetic resonance imaging. Regression analyses explored associations between cord area, grey and white matter volume, cortical activations and thickness, and disability. Subjects with spinal cord injury had impaired upper and lower limb function bilaterally, a 30% reduced cord area, smaller white matter volume in the pyramids and left cerebellar peduncle, and smaller grey matter volume and cortical thinning in the leg area of the primary motor and sensory cortex compared with controls. Functional magnetic resonance imaging revealed increased activation in the left primary motor cortex leg area during handgrip and the left primary sensory cortex face area during median nerve stimulation in subjects with spinal cord injury compared with controls, but no increased activation following tibial nerve stimulation. A smaller cervical cord area was associated with impaired upper limb function and increased activations with handgrip and median nerve stimulation, but reduced activations with tibial nerve stimulation. Increased sensory deficits were associated with increased activations in the left primary sensory cortex face area due to median nerve stimulation. In conclusion, spinal cord injury leads to cord atrophy, cortical atrophy of primary motor and sensory cortex, and cortical reorganization of the sensorimotor system. The degree of cortical reorganization is predicted by spinal atrophy and is associated with significant disability.

Dataset Information

Functional Preservation and Reorganization of Brain during Motor Imagery in Patients with Incomplete Spinal Cord Injury: A Pilot fMRI Study.

Publications

Functional Preservation and Reorganization of Brain during Motor Imagery in Patients with Incomplete Spinal Cord Injury: A Pilot fMRI Study.

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