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Preserved somatosensory conduction in complete spinal cord injury: Discomplete SCI |
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| Institution: | 1. Department of Psychiatry, University of Cambridge, Addenbrooke''s Hospital, Level E4, Box 189, Hills Road, Cambridge CB2 2QQ, UK;2. Unit of Neuroscience, School of Clinical Sciences, Pain Research Institute, Lower Lane, Liverpool L9 7AL, UK;3. Department of Molecular and Cellular Physiology, Institute of Translational Medicine (PGR), University of Liverpool, Whelan Building, Liverpool L69 3GB, UK;4. Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK;5. Walton Centre for Neurology and Neurosurgery NHS Trust, Lower Lane, Fazakerley, Liverpool L9 7JL, UK |
| Abstract: | ObjectiveSpinal cord injury (SCI) disrupts the communication between brain and body parts innervated from below-injury spinal segments, but rarely results in complete anatomical transection of the spinal cord. The aim of this study was to investigate residual somatosensory conduction in clinically complete SCI, to corroborate the concept of sensory discomplete SCI.MethodsWe used fMRI with a somatosensory protocol in which blinded and randomized tactile and nociceptive stimulation was applied on both legs (below-injury level) and one arm (above-injury level) in eleven participants with chronic complete SCI. The experimental design accounts for possible confounding mechanical (e.g. vibration) and cortico-cortical top-down mechanisms (e.g. attention/expectation).ResultsSomatosensory stimulation on below-level insensate body regions activated the somatotopically corresponding part of the contralateral primary somatosensory cortex in six out of eleven participants.ConclusionsOur results represent afferent-driven cortical activation through preserved somatosensory connections to the brain in a subgroup of participants with clinically complete SCI, i.e. sensory discomplete SCI.SignificanceIdentifying patients with residual somatosensory connections might open the door for new rehabilitative and restorative strategies as well as inform research on SCI-related conditions such as neuropathic pain and spasticity. |
| Keywords: | Spinal cord injury Functional MRI Somatosensory Discomplete Non-conscious ACC"} {"#name":"keyword" "$":{"id":"k0035"} "$$":[{"#name":"text" "_":"anterior cingulate cortex AIS"} {"#name":"keyword" "$":{"id":"k0045"} "$$":[{"#name":"text" "_":"American Spinal Injury Association Impairment Scale BA"} {"#name":"keyword" "$":{"id":"k0055"} "$$":[{"#name":"text" "_":"Brodmann area BOLD"} {"#name":"keyword" "$":{"id":"k0065"} "$$":[{"#name":"text" "_":"Blood oxygenation level-dependent fMRI"} {"#name":"keyword" "$":{"id":"k0075"} "$$":[{"#name":"text" "_":"functional magnetic resonance imaging NLI"} {"#name":"keyword" "$":{"id":"k0085"} "$$":[{"#name":"text" "_":"neurologic level of injury NRS"} {"#name":"keyword" "$":{"id":"k0095"} "$$":[{"#name":"text" "_":"Numeric Rating Scale PAS"} {"#name":"keyword" "$":{"id":"k0105"} "$$":[{"#name":"text" "_":"Perceptual Awareness Scale ROI"} {"#name":"keyword" "$":{"id":"k0115"} "$$":[{"#name":"text" "_":"regions of interest S1"} {"#name":"keyword" "$":{"id":"k0125"} "$$":[{"#name":"text" "_":"primary somatosensory cortex S2"} {"#name":"keyword" "$":{"id":"k0135"} "$$":[{"#name":"text" "_":"secondary somatosensory cortex SCI"} {"#name":"keyword" "$":{"id":"k0145"} "$$":[{"#name":"text" "_":"spinal cord injury ZPP"} {"#name":"keyword" "$":{"id":"k0155"} "$$":[{"#name":"text" "_":"zone of partial preservation |
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