title: Long-Term Motor Recovery After Severe Traumatic Brain Injury: Beyond Established Limits.
abstract: To report neural plasticity changes after severe traumatic brain injury.
  
  
  
  Case-control study.
  
  
  
  Canadian soldier, Captain Trevor Greene survived a severe open-traumatic brain injury during a 2006 combat tour in Afghanistan.
  
  
  
  Longitudinal follow-up for more than 6 years.
  
  
  
  Twelve longitudinal functional magnetic imaging (fMRI) examinations were conducted to investigate lower limb activation changes in association with clinical examination. Trevor Greene's lower limb fMRI activation was compared with control fMRI activation of (1) mental imagery of similar movement and (2) matched control subject data.
  
  
  
  Trevor Greene's motor recovery and corresponding fMRI activation increased significantly over time (F = 32.54, P < .001). Clinical measures of functional recovery correlated strongly with fMRI motor activation changes (r = 0.81, P = .001). By comparison, while Trevor Greene's mental imagery activated similar motor regions, there was no evidence of fMRI activation change over time. While comparable, control motor activation did not change over time and there was no significant mental imagery activation.
  
  
  
  Motor function recovery can occur beyond 6 years after severe traumatic brain injury, both in neural plasticity and clinical outcome. This demonstrates that continued benefits in physical function due to rehabilitative efforts can be achieved for many years following injury. The finding challenges current practices and assumptions in rehabilitation following traumatic brain injury.
authors.affiliation: NeuroTech Lab, Surrey Memorial Hospital, Simon Fraser University and Fraser Health Authority, Metro Vancouver, British Columbia, Canada (Drs D'Arcy and Song, Ms Greene, and Messrs Ghosh Hajra and Greene); Institute for Biodiagnostics (Atlantic), National Research Council, Halifax, Nova Scotia, Canada (Drs D'Arcy, Song, Gawryluk, and Mr Ghosh Hajra); Department of Psychology, University of Victoria, Victoria, British Columbia, Canada (Drs Lindsay and Gawryluk and Ms Mayo); Pacific Occupational Therapy Services, Victoria, British Columbia, Canada (Ms Mandziuk); and Department of Medical Imaging, Vancouver Island Health Authority, British Columbia, Canada (Dr Mathieson).
authors.forename: Ryan C N
authors.initials: RC
authors.lastname: DʼArcy
authors.forename: D Stephen
authors.initials: DS
authors.lastname: Lindsay
authors.forename: Xiaowei
authors.initials: X
authors.lastname: Song
authors.forename: Jodie R
authors.initials: JR
authors.lastname: Gawryluk
authors.forename: Debbie
authors.initials: D
authors.lastname: Greene
authors.forename: Chantel
authors.initials: C
authors.lastname: Mayo
authors.forename: Sujoy
authors.initials: S
authors.lastname: Ghosh Hajra
authors.forename: Lila
authors.initials: L
authors.lastname: Mandziuk
authors.forename: John
authors.initials: J
authors.lastname: Mathieson
authors.forename: Trevor
authors.initials: T
authors.lastname: Greene
mesh_terms: D000328:Adult; D000070642:Brain Injuries, Traumatic / Q000503:physiopathology* / Q000534:rehabilitation*; D002170:Canada; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D009473:Neuronal Plasticity; D020127:Recovery of Function