title: Preserved somatosensory conduction in a patient with complete cervical spinal cord injury.
abstract: OBJECTIVE
  Neurophysiological investigation has shown that patients with clinically complete spinal cord injury can have residual motor sparing ("motor discomplete"). In the current study somatosensory conduction was assessed in a patient with clinically complete spinal cord injury and a novel methodology for assessing such preservation is described, in this case indicating "sensory discomplete" spinal cord injury.
  
  
  METHODS
  Blood oxygenation level-dependent functional magnetic resonance imaging (BOLD fMRI) was used to examine the somatosensory system in a healthy subject and in a subject with a clinically complete cervical spinal cord injury, by applying tactile stimulation above and below the level of spinal cord injury, with and without visual feedback.
  
  
  RESULTS
  In the participant with spinal cord injury, somatosensory stimulation below the neurological level of the lesion gave rise to BOLD signal changes in the corresponding areas of the somatosensory cortex. Visual feedback of the stimulation strongly modulated the somatosensory BOLD signal, implying that cortico-cortical rather than spino-cortical connections can drive activity in the somatosensory cortex. Critically, BOLD signal change was also evident when the visual feedback of the stimulation was removed, thus demonstrating sensory discomplete spinal cord injury.
  
  
  CONCLUSIONS
  Given the existence of sensory discomplete spinal cord injury, preserved but hitherto undetected somatosensory conduction might contribute to the unexplained variability related to, for example, the propensity to develop decubitus ulcers and neuropathic pain among patients with clinically complete spinal cord injury.
authors: Umeå Center for Functional Brain Imaging (UFBI), Umeå, Sweden.
authors: Amar
authors: A
authors: Awad
authors: Richard
authors: R
authors: Levi
authors: Lenita
authors: L
authors: Lindgren
authors: Claes
authors: C
authors: Hultling
authors: Göran
authors: G
authors: Westling
authors: Lars
authors: L
authors: Nyberg
authors: Johan
authors: J
authors: Eriksson
mesh_terms: D066193:Cervical Cord / Q000293:injuries*; D005246:Feedback; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009431:Neural Conduction / Q000502:physiology; D009437:Neuralgia / Q000209:etiology / Q000503:physiopathology; D010100:Oxygen / Q000097:blood; D010812:Physical Stimulation / Q000379:methods; D013003:Somatosensory Cortex / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D010100:Oxygen