title: Short-term cortical plasticity associated with feedback-error learning after locomotor training in a patient with incomplete spinal cord injury.
abstract: OBJECTIVE
  For rehabilitation strategies to be effective, training should be based on principles of motor learning, such as feedback-error learning, that facilitate adaptive processes in the nervous system by inducing errors and recalibration of sensory and motor systems. This case report suggests that locomotor resistance training can enhance somatosensory and corticospinal excitability and modulate resting-state brain functional connectivity in a patient with motor-incomplete spinal cord injury (SCI).
  
  
  METHODS
  The short-term cortical plasticity of a 31-year-old man who had sustained an incomplete SCI 9.5 years previously was explored in response to body-weight-supported treadmill training with velocity-dependent resistance applied with a robotic gait orthosis. The following neurophysiological and neuroimaging measures were recorded before and after training. Sensory evoked potentials were elicited by electrical stimulation of the tibial nerve and recorded from the somatosensory cortex. Motor evoked potentials were generated with transcranial magnetic stimulation applied over the tibialis anterior muscle representation in the primary motor cortex. Resting-state functional magnetic resonance imaging was performed to evaluate short-term changes in patterns of brain activity associated with locomotor training.
  
  
  RESULTS
  Somatosensory excitability and corticospinal excitability were observed to increase after locomotor resistance training. Motor evoked potentials increased (particularly at higher stimulation intensities), and seed-based resting-state functional magnetic resonance imaging analyses revealed increased functional connectivity strength in the motor cortex associated with the less affected side after training.
  
  
  CONCLUSIONS
  The observations suggest evidence of short-term cortical plasticity in 3 complementary neurophysiological measures after one session of locomotor resistance training. Future investigation in a sample of people with incomplete SCI will enhance the understanding of potential neural mechanisms underlying the behavioral response to locomotor resistance training.
authors.affiliation: A.E. Chisholm, PhD, School of Kinesiology/International Collaboration on Repair Discoveries, University of British Columbia, 818 W 10th Ave, Vancouver, British Columbia, Canada V5Z 1M9. achisholm@icord.org.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Chisholm
authors.affiliation: S. Peters, MPT, Graduate Department of Rehabilitation Sciences, University of British Columbia.
authors.forename: Sue
authors.initials: S
authors.lastname: Peters
authors.affiliation: M.R. Borich, DPT, PhD, Department of Physical Therapy, University of British Columbia.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Borich
authors.affiliation: L.A. Boyd, PT, PhD, Department of Physical Therapy, University of British Columbia.
authors.forename: Lara A
authors.initials: LA
authors.lastname: Boyd
authors.affiliation: T. Lam, PT, PhD, School of Kinesiology/International Collaboration on Repair Discoveries, University of British Columbia.
authors.forename: Tania
authors.initials: T
authors.lastname: Lam
mesh_terms: D000328:Adult; D019054:Evoked Potentials, Motor / Q000502:physiology; D005246:Feedback; D020233:Gait Disorders, Neurologic / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000502:physiology*; D009473:Neuronal Plasticity / Q000502:physiology*; D009989:Orthotic Devices; D026741:Physical Therapy Modalities; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D050781:Transcranial Magnetic Stimulation