Reorganization of brain function in people with CNS damage has been identified as one of the fundamental mechanisms involved in the recovery of sensori-motor function. Spinal cord injury (SCI) brain mapping studies during motor tasks aim for assessing the reorganization and preservation of brain networks involved in motor control. Revealing the activation of cortical and sub-cortical brain areas in people with SCI can indicate principal patterns of brain reorganization when the neurotrauma is distal to the brain. This review assessed brain activation after SCI in terms of intensity, volume, and somatotopic localization, as well as preservation of activation during attempted and/or imagined movements. Twenty-five studies meeting the inclusion criteria could be identified in MEDLINE (1980 to January 2008. Relevant characteristics of studies (level of lesion, time after injury, motor task) and mapping techniques varied widely. Changes in brain activation were found in both cortical and subcortical areas of individuals with SCI. In addition, several studies described a shift in the region of brain activation. These patterns appeared to be dynamic and influenced by the level, completeness and time after injury, as well as extent of clinical recovery. In addition, several aspects of reorganization of brain function following SCI resembled those reported in stroke. This review demonstrates that brain networks involved in different demands of motor control remain responsive even in chronic paralysis. These findings imply that therapeutic strategies aiming for restoring spinal cord function even in people with chronic SCI can build on a preserved competent brain control.

Functional neuroimaging techniques have allowed for investigations into the mechanisms of agerelated deterioration in motor control. This study used functional Magnetic Resonance Imaging (fMRI) to investigate age related differences in the control of grip force magnitude. Using an event-related design, fMRI scans were completed on 13 older adults, and 13 gender matched younger adults, while using their dominant hand to squeeze a rubber bulb for 4s at 10%, 40% or 70% of their maximum voluntary contraction. Both groups were able to match the relative force targets, however the older adults produced significantly lower levels of absolute force. fMRI analysis consisted of a 1) region of interest (ROI) approach to detect differences in selected motor areas within brain and 2) a voxel-wise whole brain comparison to find areas of differential activation that were not defined a priori between the older and younger group. The ROI analysis revealed that despite producing lower levels of absolute force, the older adults showed higher levels of activity predominantly in subcortical structures (putamen, thalamus and cerebellum) when compared to the younger group. The older adults also showed higher levels of activity in the ipsilateral ventral premotor cortex. A total of 19 of the 22 ROIs analyzed showed a significant main effect of the required force-level. In the majority of the ROIs that showed a significant force effect there were no significant differences in the magnitude of the blood-oxygen-level-dependent (BOLD) signal between the 10% and 40% conditions but a significantly higher BOLD signal in the 70% condition, suggesting that the modulation of brain activation with grip force may not be controlled in a linear fashion. It was also found that the older adult group demonstrate higher levels of activation in 7 areas during a force production task at higher force levels using a voxelwise analysis. The 7 clusters that showed significant differences tended to be areas that are involved in visual-spatial and executive processing. The results of this study revealed that older adults require significantly higher activation of several areas to perform the same motor task as younger adults. Higher magnitudes of the BOLD signal in older adults may represent a compensatory pattern to counter age related deterioration in motor control systems.Corresponding Author: Janice J. Eng, PT, OT, Ph.D., Professor, Department of Physical Therapy, University of British Columbia, 212-2177 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3, Janice.Eng@ubc.ca, Phone: IntroductionThe normal aging process leads to several declines of the motor system that are related to changes within the central nervous system, peripheral nervous system and the musculoskeletal system (Seidler et al., 2010). These changes have the potential to lead to decreased motor performance with aging, which has been observed in the forms of decreased coordination, increased movement variability, slower movements and difficulties with balance and gait (Seidler et al., 2...

Background-Past studies have identified reorganization of brain activity in relation to motor outcome through standardized laboratory measures, which are quantifiable surrogates for arm use in real-life. In contrast, accelerometers can provide a real-life estimate of arm and hand usage.