Highlights
- •We examined cortical activation during an illusory walking paradigm in persons with spinal cord injury.
- •Persons with spinal cord injury showed activation in the somatosensory cortex.
- •Able-bodied persons showed activation in the premotor cortical areas.
Abstract
Objective
To determine the location of cortical activation during a visual illusion walking
paradigm, a recently proposed treatment for spinal cord injury (SCI)–related neuropathic
pain, in persons with SCI compared with able-bodied controls.
Design
Pilot experimental functional magnetic resonance imaging (fMRI) trial.
Setting
Outpatient rehabilitation clinic.
Participants
Persons with paraplegia (n=3) and able-bodied participants (n=5) were included in
this study.
Interventions
Not applicable.
Main Outcome Measure
Cortical activation as measured by the blood oxygenation level-dependent method of
fMRI.
Results
During visually illusory walking there was significant activation in the somatosensory
cortex among those with SCI. In contrast, able-bodied participants showed little to
no significant activation in this area, but they showed activation in the frontal
and premotor areas.
Conclusions
Treatment modalities for SCI-related neuropathic pain that are based on sensory input
paradigms (eg, virtual walking, visual illusory walking) may work by targeting the
somatosensory cortex, an area that has been previously found to functionally reorganize
after SCI.
Keywords
List of abbreviations:
fMRI (functional magnetic resonance imaging), SCI (spinal cord injury)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Introduction: semantic, epidemiologic, and educational issues.in: Casey K.L. Pain and central nervous system disease: the central pain syndromes. Raven Pr, New York1991: 13-29
- Treatments for chronic pain in persons with spinal cord injury: a survey study.J Spinal Cord Med. 2006; 29: 109-117
- Cortical origin of pathological pain.Lancet. 1999; 354: 1464-1466
- Phantom limb pain: a case of maladaptive CNS plasticity?.Nat Rev Neurosci. 2006; 29: 12125-12130
- The use of visual feedback, in particular mirror visual feedback, in restoring brain function.Brain. 2009; 132: 1693-1710
- Mirror therapy for phantom limb pain.N Engl J Med. 2007; 357: 2206-2207
- Effect of sensory discrimination training on cortical reorganisation and phantom limb pain.Lancet. 2001; 357: 1763-1764
- Neuropathic pain and primary somatosensory cortex reorganization following spinal cord injury.Pain. 2009; 141: 52-59
- Using visual illusion to reduce at-level neuropathic pain in paraplegia.Pain. 2007; 130: 294-298
- Effectiveness of transcranial direct current stimulation and visual illusion on neuropathic pain in spinal cord injury.Brain. 2010; 133: 2565-2577
- Mirrored, imagined and executed movements differentially activate sensorimotor cortex in amputees with and without phantom limb pain.Pain. 2010; 149: 296-304
- Assessing the significance of focal activations using their spatial extent.Hum Brain Mapp. 1994; 1: 210-220
- The cortical modulation from the external cues during gait observation and imagination.Neurosci Lett. 2008; 443: 232-235
Article info
Publication history
Published online: November 14, 2014
Footnotes
Supported by the Rehabilitation Research Experience for Medical Students Program of the Association of Academic Physiatrists; National Institute on Disability and Rehabilitation Research (grant no. H133N110008); and National Institutes of Health (grant no. 1 K23 HD073680-01A1).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
