title: Brain activation in the acute phase of traumatic spinal cord injury.
abstract: METHODS
  Prospective clinical study.
  
  
  BACKGROUND
  The aim of the study was to investigate cortical reorganisation after traumatic spinal cord injury (TSCI) using functional magnetic resonance imaging (fMRI).
  
  
  METHODS
  Tartu University Hospital, Tartu, Estonia.
  
  
  METHODS
  We studied six right-handed tetraplegic TSCI patients at 1, 3 and 12 months after the injury and 12 age- and gender-matched healthy controls. Individuals performed simple test-rest cycles of flexion/extension of the right-hand fingers and flexion/extension of the right ankle during fMRI. The volumes of activation (VOA), maximum t-values, centres of gravity (COG) and weighted laterality indexes were calculated.
  
  
  RESULTS
  There was no recovery of neurologic function in three patients and, according to the American Spinal Injury Association (ASIA) Impairment Scale the remaining three recovered. A positive correlation between the VOA in the primary motor cortex and the ASIA impairment scale (1 month: r=0.82, P=0.002; 3 Month: r=0.63, P=0.03; 12 Month: r=0.23, P=0.52) was found. The study also revealed a pattern of cortical activation that was increased among the patients who recovered (in Brodmann area 4 (BA 4), P=0.06; BA 1-2-3-5, P=0.08; BA 6, P=0.05). During the hand task there was an expansion of COG laterally, anteriorly and inferiorly among the patients who recovered. During the hand movement the cortical activation was less lateralised among the patients compared with the controls (P<0.05).
  
  
  CONCLUSIONS
  Our study has found broadening of cortical activation and shift of COG during the first year after TSCI, depending on the recovery.
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia. liis.sabre@ut.ee
authors.forename: L
authors.initials: L
authors.lastname: Sabre
authors.forename: T
authors.initials: T
authors.lastname: Tomberg
authors.forename: J
authors.initials: J
authors.lastname: Kõrv
authors.forename: J
authors.initials: J
authors.lastname: Kepler
authors.forename: K
authors.initials: K
authors.lastname: Kepler
authors.forename: U
authors.initials: U
authors.lastname: Linnamägi
authors.forename: T
authors.initials: T
authors.lastname: Asser
mesh_terms: D000293:Adolescent; D000328:Adult; D000842:Ankle / Q000294:innervation; D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D001931:Brain Mapping; D016022:Case-Control Studies; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000294:innervation; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009068:Movement; D010100:Oxygen / Q000097:blood; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000473:pathology*; D055815:Young Adult
chemical_list: D010100:Oxygen