Non-concomitant cortical structural and functional alterations in sensorimotor areas following incomplete spinal cord injury

Neural Regeneration Research, 2017 · DOI: 10.4103/1673-5374.221165 · Published: December 1, 2017

Spinal Cord Injury Neurology Neurorehabilitation

Simple Explanation

This study investigates the relationship between brain structure and function after incomplete spinal cord injury (SCI). Researchers used fMRI to examine gray matter volume (GMV) and functional connectivity in sensorimotor areas of SCI patients and healthy controls. The study found no significant differences in GMV between the two groups, but observed decreased functional connectivity within sensorimotor areas in SCI patients. This suggests that brain function can change after SCI without corresponding changes in brain structure. The researchers also found a correlation between the strength of functional connectivity and sensory scores in SCI patients. This indicates that functional connectivity could be used as a biomarker to assess sensory function after incomplete SCI.

Study Duration

1 to 12 months post-injury

Participants

18 incomplete SCI patients and 18 healthy controls

Evidence Level

Not specified

Key Findings

1
There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects.
2
Intra-hemispheric functional connectivity between left BA1 and left BA4, and left BA1 and left BA5 was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI.
3
The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients.

Research Summary

This study explored the relationship between cortical structure and network function in sensorimotor areas following incomplete SCI using resting-state fMRI. Eighteen patients with incomplete SCI and 18 healthy subjects were compared regarding gray matter volume (GMV) and functional connectivity. The results indicated that there was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared to healthy subjects. However, decreased intra- and inter-hemispheric functional connectivity within sensorimotor areas was observed in SCI patients. Furthermore, the decreased functional connectivity between the left BA1 and the right BA4 positively correlated with ASIA sensory score in SCI patients, suggesting that functional connectivity could serve as a potential imaging biomarker for sensory function assessment.

Practical Implications

Biomarker for Sensory Function

Functional connectivity within sensorimotor areas may serve as a potential imaging biomarker for the assessment and prediction of sensory function in patients with incomplete SCI.

Non-Concomitant Alterations

Alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas are non-concomitant in patients with incomplete SCI, indicating that network functional changes may not be dependent on anatomic structure.

Rehabilitation Strategies

The findings suggest potential targets for rehabilitation strategies aimed at enhancing functional connectivity in sensorimotor areas to improve sensory function following incomplete SCI.

Study Limitations

1
The duration of SCI in patients was between 1 and 12 months, which could affect GMV.
2
The analysis of structural and functional connectivity did not include the brain stem and cerebellum.
3
Only structural and functional connectivity MRI data were combined, limiting the potential of cross-information from other modalities.

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