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Inconsistency between cortical reorganization and functional connectivity alteration in the sensorimotor cortex following incomplete cervical spinal cord injury

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Abstract

The aim of this study was to explore whether there will be any alterations in sensorimotor-related cortex and the possible causes of sensorimotor dysfunction after incomplete cervical spinal cord injury (ICSCI). Structural and resting-state functional magnetic resonance imaging (rs-fMRI) of nineteen ICSCI patients and nineteen healthy controls (HCs) was acquired. Voxel based morphometry (VBM) and tract-based spatial statistics were performed to assess differences in gray matter volume (GMV) and white matter integrity between ICSCI patients and HCs. Whole brain functional connectivity (FC) was analyzed using the results of VBM as seeds. Associations between the clinical variables and the brain changes were studied. Compared with HCs, ICSCI patients demonstrated reduced GMV in the right fusiform gyrus (FG) and left orbitofrontal cortex (OFC) but no changes in areas directly related to sensorimotor function. There were no significant differences in brain white matter. Additionally, the FC in the left primary sensorimotor cortex and cerebellum decreased when the FG and OFC, respectively, were used as seeds. Subsequent relevance analysis suggests a weak positive correlation between the left OFC’s GMV and visual analog scale (VAS) scores. In conclusion, brain structural changes following ICSCI occur mainly in certain higher cognitive regions, such as the FG and OFC, rather than in the brain areas directly related to sensation or motor control. The functional areas of the brain that are related to cognitive processing may play an important role in sensorimotor dysfunction through the decreased FC with sensorimotor areas after ICSCI. Therefore, cognition-related functional training may play an important role in rehabilitation of sensorimotor function after ICSCI.

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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

Abbreviations

ICSCI:

Incomplete cervical spinal cord injury

rs-fMRI:

Resting-state functional magnetic resonance imaging

HC:

Healthy control

VBM:

Voxel-based morphometry

GM:

Gray matter

GMV:

Gray matter volume

WM:

White matter

WMV:

White matter volume

FC:

Functional connectivity

FG:

Fusiform gyrus

OFC:

Orbitofrontal cortex

VAS:

Visual analog scale

SCI:

Spinal cord injury

SMA:

Supplementary motor area

ACC:

Anterior cingulate cortex

TBSS:

Tract-based spatial statistics

ASIA:

American Spinal Injury Association

TBI:

Traumatic brain injury

CSF:

Cerebrospinal fluid

MD:

Mean diffusivity

FA:

Fractional anisotropy

ROI:

Regions of interest

VTC:

Ventral temporal cortex

PAG:

Periaqueductal gray

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  1. Xuejing Li and Qian Chen contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Xuanwu Hospital, Capital Medical University, No. 45 Chang-chun St, Xicheng District, Beijing, China

    Xuejing Li, Xin Chen, Ling Wang, Kuncheng Li, Jie Lu & Nan Chen

  2. Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, No. 45 Chang-chun St, Xicheng District, Beijing, China

    Xuejing Li, Xin Chen, Ling Wang, Kuncheng Li, Jie Lu & Nan Chen

  3. Department of Radiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Xicheng District, Beijing, China

    Qian Chen

  4. Department of Radiology, Aerospace Central Hospital, No. 15 Yuquan Road, Haidian District, Beijing, China

    Weimin Zheng

  5. Department of Radiology, Tianjin Medical University General Hospital, No. 154, Anshan Road, Heping District, Tianjin, China

    Wen Qin

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  1. Xuejing Li
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Li, X., Chen, Q., Zheng, W. et al. Inconsistency between cortical reorganization and functional connectivity alteration in the sensorimotor cortex following incomplete cervical spinal cord injury. Brain Imaging and Behavior 14, 2367–2377 (2020). https://doi.org/10.1007/s11682-019-00190-9

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