title: Brain activation in the chronic phase of traumatic spinal cord injury.
abstract: METHODS
  Cross-sectional clinical study.
  
  
  OBJECTIVE
  Plastic changes within cortical areas occur after traumatic spinal cord injury (TSCI). The aim of the study was to assess cortical activation in the chronic phase of TSCI using functional magnetic resonance imaging (fMRI).
  
  
  METHODS
  Tartu University Hospital, Tartu, Estonia.
  
  
  METHODS
  Ten right-handed patients with paraplegia and 18 healthy controls were studied by fMRI. Individuals performed simple flexion/extension of the right hand fingers and the right ankle during fMRI. The activation volumes, maximum t values (T max) and centres of gravity (COG) were calculated.
  
  
  RESULTS
  The mean time since trauma was 1848±1046 days (range 388-4459). During hand movements, the volume of activation (VOA) in the contralateral primary motor cortex was significantly larger among the TSCI patients who did not recover compared with the controls (4112 vs 2777, P=0.02). The VOA did not enlarge during the ankle movements (2420 vs 1114, P=0.08). There was a significant relationship between the VOA in Brodmann area 4 (BA4) and American Spinal Injury Association motor score during hand movements (r=-0.67, P=0.03). A positive correlation was found during hand movements in the VOA of BA4 and time since injury (r=0.62, P=0.05).
  
  
  CONCLUSIONS
  We found increased cortical activation in the chronic phase of thoraco-lumbar TSCI that may be caused by increased use of upper limbs.
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: L
authors.initials: L
authors.lastname: Sabre
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.|Radiology Clinic, Tartu University Hospital, Tartu, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Tomberg
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: J
authors.initials: J
authors.lastname: Kõrv
authors.affiliation: Medical Technology Service, Pärnu Hospital, Pärnu, Estonia.
authors.forename: J
authors.initials: J
authors.lastname: Kepler
authors.affiliation: Institute of Physics, University of Tartu, Tartu, Estonia.
authors.forename: K
authors.initials: K
authors.lastname: Kepler
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: Ü
authors.initials: Ü
authors.lastname: Linnamägi
authors.affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia.
authors.forename: T
authors.initials: T
authors.lastname: Asser
mesh_terms: D000328:Adult; D001921:Brain / Q000098:blood supply / Q000503:physiopathology*; D002908:Chronic Disease; D005260:Female; D007839:Functional Laterality; D006225:Hand / Q000503:physiopathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D009069:Movement Disorders / Q000209:etiology; D010100:Oxygen / Q000097:blood; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000473:pathology*; D013223:Statistics as Topic; D013997:Time Factors; D055815:Young Adult
chemical_list: D010100:Oxygen