Disconnected Body Representation: Neuroplasticity Following Spinal Cord Injury

Journal of Clinical Medicine, 2019 · DOI: 10.3390/jcm8122144 · Published: December 4, 2019

Spinal Cord Injury Neurology Neuroplasticity

Simple Explanation

Following spinal cord injury (SCI), the brain undergoes reorganization due to the interruption of signals between the brain and the body. This can lead to changes in how the body is represented in the brain. This review explores how the brain adapts to the loss or alteration of sensory and motor signals from the body after SCI, considering the role of different brain structures and mechanisms in this process. Understanding these plastic changes is important for developing better rehabilitation programs and improving recovery for individuals with SCI.

Study Duration

Not specified

Participants

Individuals with spinal cord injury, amputees, and healthy controls

Evidence Level

Review

Key Findings

1
Brain reorganization after SCI involves changes in the somatosensory and motor cortices, including the expansion of facial representation into areas formerly representing the affected limbs.
2
Despite significant sensorimotor disconnection, body templates (depictive body image measures) may remain relatively stable after SCI, suggesting multiple pathways for body representation.
3
Residual ascending sensory pathways and subcortical structures play a more significant role in body representation after SCI than previously thought, challenging the traditional view of cortical reorganization.

Research Summary

This review discusses the neuroplastic changes that occur in the brain following spinal cord injury (SCI), focusing on how the brain adapts to the loss of sensory and motor signals from the affected body regions. The authors challenge the classical theory of cortical reorganization, highlighting the importance of subcortical structures and residual peripheral nervous activity in shaping body representation after SCI. The review concludes by emphasizing the need for integrated research designs and clinical procedures that consider the complex interactions between the brain and body in order to improve rehabilitation outcomes for individuals with SCI.

Practical Implications

Rehabilitation Strategies

Clinical treatments should focus on remapping inputs from affected body parts to preserved body parts, leveraging multisensory integration to enhance perceptual experience and manage chronic pain.

Research Directions

Future research should investigate the roles of subcortical structures and residual peripheral nervous activity in shaping body representation after SCI.

Personalized Medicine

Rehabilitation programs should be tailored to individual patients, taking into account factors such as the extent of neurological injury, lesion severity, time since injury, age, and subjective experiences.

Study Limitations

1
Interspecies biological differences affect neuroplasticity findings.
2
Variability in SCI effects, from slight sensory/motor reduction to complete signal abolition.
3
Limited objective evidence supports neural topographic substitution in humans compared to monkeys.

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