Preserved aspects of cortical foot control in paraplegia

Halder, Pascal; Curt, Armin; Brem, Silvia; Lang-Dullenkopf, Annette; Bücher, Kerstin; Kollias, Spyros; Brandeis, Daniel

doi:10.1016/j.neuroimage.2005.12.018

Cited by 18 publications

(19 citation statements)

References 39 publications

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“…6 Increase in the activation magnitude was reported by several researchers. 6,11,12 Some studies have not found differences in brain activation, 6,13 and two studies have reported reduced activation in individuals with TSCI. 14,15 Most of the studies have been performed in the chronic phase of injury.…”

Section: Discussionmentioning

confidence: 99%

Brain activation in the chronic phase of traumatic spinal cord injury

et al. 2015

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Study design: Cross-sectional clinical study. Objectives: Plastic changes within cortical areas occur after traumatic spinal cord injury (TSCI). The aim of the study was to assess cortical activation in the chronic phase of TSCI using functional magnetic resonance imaging (fMRI). Setting: Tartu University Hospital, Tartu, Estonia. Methods: Ten right-handed patients with paraplegia and 18 healthy controls were studied by fMRI. Individuals performed simple flexion/extension of the right hand fingers and the right ankle during fMRI. The activation volumes, maximum t values (T max) and centres of gravity (COG) were calculated. Results: The mean time since trauma was 1848 ± 1046 days (range 388-4459). During hand movements, the volume of activation (VOA) in the contralateral primary motor cortex was significantly larger among the TSCI patients who did not recover compared with the controls (4112 vs 2777, P = 0.02). The VOA did not enlarge during the ankle movements (2420 vs 1114, P = 0.08). There was a significant relationship between the VOA in Brodmann area 4 (BA4) and American Spinal Injury Association motor score during hand movements (r = − 0.67, P = 0.03). A positive correlation was found during hand movements in the VOA of BA4 and time since injury (r = 0.62, P = 0.05). INTRODUCTIONTraumatic spinal cord injury (TSCI) leads to sensorimotor loss and disruption of autonomic nervous system. 1 Although TSCI is considered an untreatable condition, several studies in animal models have demonstrated that functional recovery is feasible if any neuronal connection has been survived or is re-established.The functional reorganisation of the nervous system after injury can be divided into early and long-term changes. 2 Such changes take place in the area of injury as well as in the brain cortex. The early changes are quite transient and reflect the reinforcement of pre-existing connections. 3 The studies in patients with TSCI in the acute phase have demonstrated different shifts in the activation and changes in the area of cortical activation. 4,5 On the other hand, in the chronic phase, new connections are forming and other neural structures take a more leading role in task performance. 3 Many neuroimaging and mapping studies have also been conducted in the chronic phase of SCI. Unfortunately, the methodology of the studies and the participants have not been homogenous. 6 In this context, we tried to study cortical activation of the similar patients with chronic TSCI whose neurological deficit bore resemblance. The aim of the study was to evaluate cortical reorganisation depending on the neurological function and time since injury.

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Section: Discussionmentioning

confidence: 99%

Brain activation in the chronic phase of traumatic spinal cord injury

et al. 2015

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“…For those studies specifying gender of subjects, one third of studies used only males, while just less than one half used a combination of males and females, with males comprising 70% of the subjects. Among studies, the level and extent of SCI lesions were also variable, with seven articles involving exclusively cervical lesions Fallani et al, 2007;Jurkiewicz et al, 2007;Mattia et al, 2006;Mikulis et al, 2002;Shoham et al, 2001;Winchester et al, 2005), five articles involving lesions in the cervical to thoracic range (Cramer et al, 2005(Cramer et al, , 2007Green et al, 1998Green et al, , 1999Turner et al, 2001), eight articles involving lesions in the thoracic to lumbar range (Alkadhi et al, 2005;Curt et al, 2002a;Halder et al, 2006;Hotz-Boendermaker et al, 2008;Lotze et al, 1999Lotze et al, , 2006Sabbah et al, 2002;Turner et al, 2003), three articles involving lesions in the cervical to lumbar range (Bruehlmeier et al, 1998;Curt et al, 2002b;Lacourse et al, 1999), and one article did not specify lesion location (Castro et al, 2007). In terms of completeness of injury, five articles included exclusively complete injuries (Alkadhi et al, 2005;Castro et al, 2007;Cramer et al, 2005;Curt et al, 2002b;Turner et al, 2003), one article involved exclusively incomplete injuries (Winchester et al, 2005), 13 articles included both complete and incomplete injuries (Cramer et al, 2005(Cramer et al, , 2007Green et al, 1998Green et al, , 1998Halder et al, 2006;HotzBoendermaker...…”

Section: Subject Characteristics Of Reviewed Studiesmentioning

confidence: 99%

“…In the present review, a number of imaging modalities were used in the included articles, with the primary modality being fMRI (14 articles) (Alkadhi et al, 2005;Cramer et al, 2005Cramer et al, , 2007Curt et al, 2002a;Hotz-Boendermaker et al, 2008;Jurkiewicz et al, 2007;Lotze et al, 1999Lotze et al, , 2006Mikulis et al, 2002;Sabbah et al, 2002;Shoham et al, 2001;Turner et al, 2001Turner et al, , 2003Winchester et al, 2005) and the others including EEG (eight articles) Castro et al, 2007;Fallani et al, 2007;Green et al, 1998Green et al, , 1999Halder et al, 2006;Lacourse et al, 1999;Mattia et al, 2006) and PET (two articles) (Bruehlmeier et al, 1998;Curt et al, 2002b). The imaging and mapping modalities cited in the studies measure plasticity of the brain differently.…”

Section: Imaging -Mapping Modalities Utilized In Reviewed Studiesmentioning

confidence: 99%

Reorganization and Preservation of Motor Control of the Brain in Spinal Cord Injury: A Systematic Review

Kokotilo

Eng

Curt

2009

Journal of Neurotrauma

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135

118

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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.

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“…However, compared with recordings made in healthy individuals, the amplitude of leg muscle EMG activity evoked during assisted locomotion with body-weight support is much reduced. 26,27 The neuronal activities that underlie locomotion and SR reach a steady state some months after a human SCI. 18,28 A cSCI at this stage is characterized by the development of spasticity with exaggerated tendon tap reflexes, increased muscle tone and spasms.…”

Section: Neuronal Dysfunction After Scimentioning

confidence: 99%

Neuronal dysfunction in chronic spinal cord injury

2010

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This review describes the changes of spinal neuronal function that occur after a motor complete spinal cord injury (cSCI) in humans. In healthy subjects, polysynaptic spinal reflex (SR) evoked by non-noxious tibial nerve stimulation consists of an early SR component and rarely a late SR component. Soon after a cSCI, SR and locomotor activity are absent. After spinal shock; however, an early SR component re-appears associated with the recovery of locomotor activity in response to appropriate peripheral afferent input. Clinical signs of spasticity take place in the following months, largely as a result of nonneuronal changes. After around 1 year, the locomotor and SR activity undergo fundamental changes, that is, the electromyographic amplitude in the leg muscles during assisted locomotion exhaust rapidly, accompanied by a shift from early to dominant late SR components. The exhaustion of locomotor activity is also observed in non-ambulatory patients with an incomplete spinal cord injury (SCI). At about 1 year after injury, in most cSCI subjects the neuronal dysfunction is fully established and remains more or less stable in the following years. It is assumed that in chronic SCI, the patient's immobility resulting in a reduced input from supraspinal and peripheral sources leads to a predominance of inhibitory drive within spinal neuronal circuitries underlying locomotor pattern and SR generation. Training of spinal interneuronal circuits including the enhancement of an appropriate afferent input might serve as an intervention to prevent neuronal dysfunction after an SCI.

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Preserved aspects of cortical foot control in paraplegia

Cited by 18 publications

References 39 publications

Brain activation in the chronic phase of traumatic spinal cord injury

Brain activation in the chronic phase of traumatic spinal cord injury

Reorganization and Preservation of Motor Control of the Brain in Spinal Cord Injury: A Systematic Review

Neuronal dysfunction in chronic spinal cord injury

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