How does the human brain deal with a spinal cord injury?
Article first published online: 25 DEC 2001
European Journal of Neuroscience
Volume 10, Issue 12, pages 3918–3922, December 1998
How to Cite
Bruehlmeier, M., Dietz, V., Leenders, K. L., Roelcke, U., Missimer, J. and Curt, A. (1998), How does the human brain deal with a spinal cord injury?. European Journal of Neuroscience, 10: 3918–3922. doi: 10.1046/j.1460-9568.1998.00454.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- Received 8 June 1998, revised 20 August 1998, accepted 10 September 1998
- brain plasticity;
- hand movement;
- spinal cord injury
The primary sensorimotor cortex of the adult brain is capable of significant reorganization of topographic maps after deafferentation and de-efferentation. Here we show that patients with spinal cord injury exhibit extensive changes in the activation of cortical and subcortical brain areas during hand movements, irrespective of normal (paraplegic) or impaired (tetraplegic patients) hand function. Positron emission tomography ([15O]-H2O-PET) revealed not only an expansion of the cortical ‘hand area' towards the cortical ‘leg area', but also an enhanced bilateral activation of the thalamus and cerebellum. The areas of the brain which were activated were qualitatively the same in both paraplegic and tetraplegic patients, but differed quantitatively as a function of the level of their spinal cord injury. We postulate that the changes in brain activation following spinal cord injury may reflect an adaptation of hand movement to a new body reference scheme secondary to a reduced and altered spino-thalamic and spino-cerebellar input.