Using fMRI to study brain reorganization after spinal cord injury

Background and Aim: Spinal decompression therapy can be used to treat disc bulges and herniations, disc degeneration, sciatica, spinal stenosis, arthritis, facet syndrome, and chronic pain in the low back or neck. Spinal decompression is FDA cleared, non-surgical, and has been shown to do the following: Relieve the pain associated with disc degeneration, herniated discs, facet syndrome, and sciatica and decrease pressure inside spinal discs, encouraging increased protein synthesis and healing. Without medical intervention, the natural recovery process following spinal cord compression is slow and largely depends on the extent of the injury sustained. Methods Currently, magnetic resonance imaging (MRI) is regarded as a gold standard for diagnostic and predictive imaging. Recently, resting-state functional MRI (rs-fMRI), which enables visualization of brain functional connectivity (FC) in the absence of tasks, has attracted attention in various fields, including neurodegenerative diseases and chronic pain. FC refers to the functionally integrated relationship between spatially separated brain regions. Rs-fMRI is particularly suitable for use with patients because of their difficulties in performing tasks due to paralysis. Results Neuroimaging studies in humans have affirmed that rapid cortical and subcortical reorganization are a common occurrence after spinal cord injury. It is a noninvasive tool that measures conduction in the descending corticospinal pathways and is capable of rapidly evaluating output assessing the functional organization and reorganization of the human motor cortex. Conclusion: As a result, only three clusters (FCs of the primary visual cortex, left intracalcarine cortex, and left lingual gyrus with the right superior frontal gyrus) showed significant inter-group differences and correlations with clinical recovery (postoperative gain in the ۱۰-second test). Importantly, one cluster [an FC of the left supracalcarine cortex (a visual area) and the right superior frontal gyrus] also showed a significant difference in the pre-post comparison. Taken together, these findings strongly indicate the importance of cortical reorganization in sensorimotor function improvement after spinal cord injury. These findings provide evidence to further support clinical, electrophysiological, and imaging data, suggesting modulation of neuroplasticity in response to spinal cord lesions. Additionally, in the recovery period, the extent of synaptic transmission and reorganization is dependent on time after the initial insult to the spinal cord as well as the variable degree of residual spinal cord atrophy.

کلیدواژه ها:

Brain ، reorganization ، Spinal cord injury ، Spinal decompression therapy