title: Motor recovery at 6 months after admission is related to structural and functional reorganization of the spine and brain in patients with spinal cord injury.
abstract: This study aimed to explore structural and functional reorganization of the brain in the early stages of spinal cord injury (SCI) and identify brain areas that contribute to motor recovery. We studied 25 patients with SCI, including 10 with good motor recovery and 15 with poor motor recovery, along with 25 matched healthy controls. The mean period post-SCI was 9.2 ± 3.5 weeks in good recoverers and 8.8 ± 2.6 weeks in poor recoverers. All participants underwent structural and functional MRI on a 3-T magnetic resonance system. We evaluated differences in cross-sectional spinal cord area at the C2/C3 level, brain cortical thickness, white matter microstructure, and functional connectivity during the resting state among the three groups. We also evaluated associations between structural and functional reorganization and the rate of motor recovery. After SCI, compared with good recoverers, poor recoverers had a significantly decreased cross-sectional spinal cord area, cortical thickness in the right supplementary motor area and premotor cortex, and fractional anisotropy (FA) in the right primary motor cortex and posterior limb of the internal capsule. Meanwhile, poor recoverers showed decreased functional connectivity between the primary motor cortex and higher order motor areas (supplementary motor area and premotor cortex), while good recoverers showed increased functional connectivity among these regions. The structural and functional reorganization of the spine and brain was associated with motor recovery rate in all SCI patients. In conclusion, structural and functional reorganization of the spine and brain directly affected the motor recovery of SCI. Less structural atrophy and enhanced functional connectivity are associated with good motor recovery in patients with SCI. Multimodal imaging has the potential to predict motor recovery in the early stage of SCI. Hum Brain Mapp 37:2195-2209, 2016. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jingming
authors.initials: J
authors.lastname: Hou
authors.affiliation: Department of Orthopedics, Chinese PLA Beijing Army General Hospital, Beijing, China.|Department of Orthopedics, Fuzhou General Hospital, Nanjing Military Command, Fuzhou, China.
authors.forename: Zimin
authors.initials: Z
authors.lastname: Xiang
authors.affiliation: Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Rubing
authors.initials: R
authors.lastname: Yan
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Yongtao
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Chinese PLA Beijing Army General Hospital, Beijing, China.
authors.forename: Jianfeng
authors.initials: J
authors.lastname: Zhong
authors.affiliation: Department of Orthopedics, Chinese PLA Beijing Army General Hospital, Beijing, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Haitao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Radiology, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Jixiang
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Orthopedics, Chinese PLA Beijing Army General Hospital, Beijing, China.
authors.forename: Tiansheng
authors.initials: T
authors.lastname: Sun
authors.affiliation: Department of Rehabilitation, Southwest Hospital, Third Military Medical University, Chongqing, China.
authors.forename: Hongliang
authors.initials: H
authors.lastname: Liu
mesh_terms: D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000000981:diagnostic imaging / Q000503:physiopathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology; D015999:Multivariate Analysis; D009473:Neuronal Plasticity / Q000502:physiology*; D009929:Organ Size; D011379:Prognosis; D020127:Recovery of Function / Q000502:physiology*; D012044:Regression Analysis; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000534:rehabilitation*; D016896:Treatment Outcome; D055815:Young Adult
keywords: atrophy; cortical reorganization; magnetic resonance imaging; motor recovery; spinal cord injury