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Disability, atrophy and cortical reorganization following spinal cord injury

The impact of traumatic spinal cord injury on structural integrity, cortical reorganization and ensuing disability is variable and may depend on a dynamic interaction between the severity of local damage and the capacity of the brain for plastic reorganization. We investigated trauma-induced anatomi...

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Autores principales: Freund, Patrick, Weiskopf, Nikolaus, Ward, Nick S., Hutton, Chloe, Gall, Angela, Ciccarelli, Olga, Craggs, Michael, Friston, Karl, Thompson, Alan J.
Formato: Texto
Lenguaje:English
Publicado: Oxford University Press 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102242/
https://www.ncbi.nlm.nih.gov/pubmed/21586596
http://dx.doi.org/10.1093/brain/awr093
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author Freund, Patrick
Weiskopf, Nikolaus
Ward, Nick S.
Hutton, Chloe
Gall, Angela
Ciccarelli, Olga
Craggs, Michael
Friston, Karl
Thompson, Alan J.
author_facet Freund, Patrick
Weiskopf, Nikolaus
Ward, Nick S.
Hutton, Chloe
Gall, Angela
Ciccarelli, Olga
Craggs, Michael
Friston, Karl
Thompson, Alan J.
author_sort Freund, Patrick
collection PubMed
description The impact of traumatic spinal cord injury on structural integrity, cortical reorganization and ensuing disability is variable and may depend on a dynamic interaction between the severity of local damage and the capacity of the brain for plastic reorganization. We investigated trauma-induced anatomical changes in the spinal cord and brain, and explored their relationship to functional changes in sensorimotor cortex. Structural changes were assessed using cross-sectional cord area, voxel-based morphometry and voxel-based cortical thickness of T(1)-weighted images in 10 subjects with cervical spinal cord injury and 16 controls. Cortical activation in response to right-sided (i) handgrip; and (ii) median and tibial nerve stimulation were assessed using functional magnetic resonance imaging. Regression analyses explored associations between cord area, grey and white matter volume, cortical activations and thickness, and disability. Subjects with spinal cord injury had impaired upper and lower limb function bilaterally, a 30% reduced cord area, smaller white matter volume in the pyramids and left cerebellar peduncle, and smaller grey matter volume and cortical thinning in the leg area of the primary motor and sensory cortex compared with controls. Functional magnetic resonance imaging revealed increased activation in the left primary motor cortex leg area during handgrip and the left primary sensory cortex face area during median nerve stimulation in subjects with spinal cord injury compared with controls, but no increased activation following tibial nerve stimulation. A smaller cervical cord area was associated with impaired upper limb function and increased activations with handgrip and median nerve stimulation, but reduced activations with tibial nerve stimulation. Increased sensory deficits were associated with increased activations in the left primary sensory cortex face area due to median nerve stimulation. In conclusion, spinal cord injury leads to cord atrophy, cortical atrophy of primary motor and sensory cortex, and cortical reorganization of the sensorimotor system. The degree of cortical reorganization is predicted by spinal atrophy and is associated with significant disability.
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spelling pubmed-31022422011-05-26 Disability, atrophy and cortical reorganization following spinal cord injury Freund, Patrick Weiskopf, Nikolaus Ward, Nick S. Hutton, Chloe Gall, Angela Ciccarelli, Olga Craggs, Michael Friston, Karl Thompson, Alan J. Brain Original Articles The impact of traumatic spinal cord injury on structural integrity, cortical reorganization and ensuing disability is variable and may depend on a dynamic interaction between the severity of local damage and the capacity of the brain for plastic reorganization. We investigated trauma-induced anatomical changes in the spinal cord and brain, and explored their relationship to functional changes in sensorimotor cortex. Structural changes were assessed using cross-sectional cord area, voxel-based morphometry and voxel-based cortical thickness of T(1)-weighted images in 10 subjects with cervical spinal cord injury and 16 controls. Cortical activation in response to right-sided (i) handgrip; and (ii) median and tibial nerve stimulation were assessed using functional magnetic resonance imaging. Regression analyses explored associations between cord area, grey and white matter volume, cortical activations and thickness, and disability. Subjects with spinal cord injury had impaired upper and lower limb function bilaterally, a 30% reduced cord area, smaller white matter volume in the pyramids and left cerebellar peduncle, and smaller grey matter volume and cortical thinning in the leg area of the primary motor and sensory cortex compared with controls. Functional magnetic resonance imaging revealed increased activation in the left primary motor cortex leg area during handgrip and the left primary sensory cortex face area during median nerve stimulation in subjects with spinal cord injury compared with controls, but no increased activation following tibial nerve stimulation. A smaller cervical cord area was associated with impaired upper limb function and increased activations with handgrip and median nerve stimulation, but reduced activations with tibial nerve stimulation. Increased sensory deficits were associated with increased activations in the left primary sensory cortex face area due to median nerve stimulation. In conclusion, spinal cord injury leads to cord atrophy, cortical atrophy of primary motor and sensory cortex, and cortical reorganization of the sensorimotor system. The degree of cortical reorganization is predicted by spinal atrophy and is associated with significant disability. Oxford University Press 2011-06 2011-05-17 /pmc/articles/PMC3102242/ /pubmed/21586596 http://dx.doi.org/10.1093/brain/awr093 Text en © The Author(s) 2011. Published by Oxford University Press on behalf of Brain. http://creativecommons.org/licenses/by-nc/2.5 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Articles
Freund, Patrick
Weiskopf, Nikolaus
Ward, Nick S.
Hutton, Chloe
Gall, Angela
Ciccarelli, Olga
Craggs, Michael
Friston, Karl
Thompson, Alan J.
Disability, atrophy and cortical reorganization following spinal cord injury
title Disability, atrophy and cortical reorganization following spinal cord injury
title_full Disability, atrophy and cortical reorganization following spinal cord injury
title_fullStr Disability, atrophy and cortical reorganization following spinal cord injury
title_full_unstemmed Disability, atrophy and cortical reorganization following spinal cord injury
title_short Disability, atrophy and cortical reorganization following spinal cord injury
title_sort disability, atrophy and cortical reorganization following spinal cord injury
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3102242/
https://www.ncbi.nlm.nih.gov/pubmed/21586596
http://dx.doi.org/10.1093/brain/awr093
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