Reorganization of the somatosensory pathway after subacute incomplete cervical cord injury

NeuroImage: Clinical, 2019 · DOI: https://doi.org/10.1016/j.nicl.2019.101674 · Published: January 9, 2019

Spinal Cord Injury Neuroimaging Neurology

Simple Explanation

This study investigates how the brain's sensory processing changes after a traumatic spinal cord injury (SCI), focusing on the somatosensory system, which handles touch and sensation. The researchers used functional MRI (fMRI) to observe brain activity during sensory stimulation and voxel-based morphometry (VBM) to assess structural changes in the brain. The findings suggest that after a spinal cord injury, the brain might use an alternative pathway to process sensory information, involving the cerebellum and brainstem, instead of the classical pathway.

Study Duration

Within 2 months postinjury

Participants

13 patients with subacute incomplete cervical cord injury and 13 age- and sex-matched healthy controls

Evidence Level

Not specified

Key Findings

1
ICCI patients exhibited decreased activation in the left postcentral gyrus (postCG), the brainstem (midbrain and right pons) and the right cerebellar lobules IV-VI compared to healthy controls.
2
A significant positive association was found between the activation in the left PostCG and the activation in both the brainstem and the right cerebellar lobules IV-VI.
3
The decrease in gray matter volume (GMV) was detected in the left superior parietal lobule (SPL) and a decrease of white matter volume (WMV) was observed in the right temporal lobe, the right occipital lobe, and the right calcarine gyrus.

Research Summary

The study investigates brain functional and structural reorganization in patients with subacute incomplete cervical cord injury (ICCI) using fMRI and voxel-based morphometry. The results suggest that an alternative somatosensory pathway may be utilized after SCI, involving the ipsilateral cerebellum, brainstem, and contralateral primary somatosensory cortex, rather than the classical pathway. The study identifies structural changes including decreased gray matter volume in the left superior parietal lobule and decreased white matter volume in the right temporal, occipital, and calcarine gyri.

Practical Implications

New Theoretical Basis

The study provides a new theoretical basis for understanding the mechanism of sensory-related brain reorganization after SCI.

Rehabilitation Therapies

The findings may provide valuable information for developing new and effective rehabilitation therapies based on the identified alternative pathway.

Understanding Sensory Impairment

Identifying an alternative sensory pathway can help in understanding the impairment of the sensory function following SCI.

Study Limitations

1
The sample size was relatively small.
2
As a cross-sectional study, this work was not conducted as a longitudinal study.
3
Patients in this study all had incomplete SCI, we cannot simply apply the mechanism of sensory impairment to the complete patients, and further studies on complete SCI are needed.

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