Rethinking the Body in the Brain after Spinal Cord Injury

J. Clin. Med., 2022 · DOI: 10.3390/jcm11020388 · Published: January 13, 2022

Spinal Cord Injury Neurology Neuroplasticity

Simple Explanation

Spinal cord injuries disrupt the body's connection to the brain, affecting movement and sensation. Research shows these injuries cause changes beyond the directly affected areas, influencing much of the central nervous system. This paper suggests viewing the affected body as the main point of focus to better understand conflicting research findings. It examines how the brain adapts its representation of different body parts after spinal cord injury. Understanding how the brain adapts to these changes is important for improving rehabilitation strategies and effectively using modern robotic technologies to assist patients.

Study Duration

Not specified

Participants

Not specified

Evidence Level

Not specified

Key Findings

1
Studies indicate that even in cases of complete SCI, sensory pathways may remain intact, with sensory information still reaching the brain without the patient's conscious awareness.
2
Research shows that the brain's structural representation of body areas below the injury remains relatively stable over time, while activation patterns and intensity may change due to compensatory processes.
3
Following SCI, the face representation in the brain may expand into areas previously dedicated to the hand, but this remapping's functional significance and consistency require further investigation.

Research Summary

Spinal cord injury (SCI) leads to neuroplastic changes throughout the central nervous system (CNS), affecting sensorimotor and autonomic pathways. These changes extend beyond the primary sensorimotor cortices. The review focuses on how SCI impacts body representation, particularly in the lower limbs, trunk and upper limbs, and head and face. It highlights structural and functional neuroplastic events following SCI. The paper concludes that understanding how the brain processes signals after SCI is crucial for improving rehabilitation and the use of assistive devices, emphasizing the importance of considering somatotopic areas for focal stimulation.

Practical Implications

Rehabilitation Strategies

A better understanding of neural plasticity after SCI can lead to more targeted and effective rehabilitation strategies.

Assistive Device Development

Insights into brain reorganization can inform the design and application of assistive devices, such as robotic technologies, to improve patient outcomes.

Pain Management

Understanding the relationship between brain changes and neuropathic pain may lead to new approaches for pain management in SCI patients.

Study Limitations

1
Heterogeneity in the extent and severity of SCI among patients leads to discrepancies in observed brain activity changes.
2
The influence of factors like disease duration, age, sensory experience, and rehabilitation exposure on brain reorganization needs further investigation.
3
Longitudinal studies are needed to fully understand the progressive development of neuroplasticity processes across different time scales after SCI.

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