scholarly journals Spinal cord injury affects the interplay between visual and sensorimotor representations of the body

2016 ◽  
Vol 6 (1) ◽  
Author(s):  
Silvio Ionta ◽  
Michael Villiger ◽  
Catherine R Jutzeler ◽  
Patrick Freund ◽  
Armin Curt ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Relative Weight ◽  
Body Representation ◽  
The Body ◽  
Lower Limbs ◽  
Whole Body ◽  
Body Parts ◽  
Postural Changes ◽  
Cord Injury

Abstract The brain integrates multiple sensory inputs, including somatosensory and visual inputs, to produce a representation of the body. Spinal cord injury (SCI) interrupts the communication between brain and body and the effects of this deafferentation on body representation are poorly understood. We investigated whether the relative weight of somatosensory and visual frames of reference for body representation is altered in individuals with incomplete or complete SCI (affecting lower limbs’ somatosensation), with respect to controls. To study the influence of afferent somatosensory information on body representation, participants verbally judged the laterality of rotated images of feet, hands and whole-bodies (mental rotation task) in two different postures (participants’ body parts were hidden from view). We found that (i) complete SCI disrupts the influence of postural changes on the representation of the deafferented body parts (feet, but not hands) and (ii) regardless of posture, whole-body representation progressively deteriorates proportionally to SCI completeness. These results demonstrate that the cortical representation of the body is dynamic, responsive and adaptable to contingent conditions, in that the role of somatosensation is altered and partially compensated with a change in the relative weight of somatosensory versus visual bodily representations.

scholarly journals Cognitive Training Improves Disconnected Limbs’ Mental Representation and Peripersonal Space after Spinal Cord Injury

2021 ◽  
Vol 18 (18) ◽  
pp. 9589
Author(s):  
Valentina Moro ◽  
Michela Corbella ◽  
Silvio Ionta ◽  
Federico Ferrari ◽  
Michele Scandola
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mental Representation ◽  
Body Representation ◽  
Peripersonal Space ◽  
Physical Rehabilitation ◽  
Lower Limbs ◽  
Body Parts ◽  
Rehabilitation Programs ◽  
Cord Injury

Paraplegia following spinal cord injury (SCI) affects the mental representation and peripersonal space of the paralysed body parts (i.e., lower limbs). Physical rehabilitation programs can improve these aspects, but the benefits are mostly partial and short-lasting. These limits could be due to the absence of trainings focused on SCI-induced cognitive deficits combined with traditional physical rehabilitation. To test this hypothesis, we assessed in 15 SCI-individuals the effects of adding cognitive recovery protocols (motor imagery–MI) to standard physical rehabilitation programs (Motor+MI training) on mental body representations and space representations, with respect to physical rehabilitation alone (control training). Each training comprised at least eight sessions administered over two weeks. The status of participants' mental body representation and peripersonal space was assessed at three time points: before the training (T0), after the training (T1), and in a follow-up assessment one month later (T2). The Motor+MI training induced short-term recovery of peripersonal space that however did not persist at T2. Body representation showed a slower neuroplastic recovery at T2, without differences between Motor and the Motor+MI. These results show that body and space representations are plastic after lesions, and open new rehabilitation perspectives.

scholarly journals Embodying their own wheelchair modifies extrapersonal space perception in people with spinal cord injury

2019 ◽  
Author(s):  
Michele Scandola ◽  
Gaetano Tieri ◽  
Renato Avesani ◽  
Massimo Brambilla ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Reaction Times ◽  
Space Perception ◽  
Body Representation ◽  
The Body ◽  
Lower Limbs ◽  
Space Representation ◽  
Body Parts ◽  
Extrapersonal Space ◽  
Cord Injury

Despite the many links between body representation, acting and perceiving the environment, no research has to date explored whether specific tool embodiment in conditions of sensorimotor deprivation influences extrapersonal space perception. We tested 20 spinal cord injured (SCI) individuals to investigate whether specific wheelchair embodiment interacts with extrapersonal space representation. As a measure of wheelchair embodiment, we used a Body View Enhancement Task in which participants (either sitting in their own wheelchair or in one which they had never used before) were asked to respond promptly to flashing lights presented on their above- and below-lesion body parts. Similar or slower reaction times (RT) to stimuli on the body and wheelchair indicate, respectively, the presence or absence of tool embodiment. The RTs showed that the participants embodied their own wheelchair but not the other one. Moreover, they coded their deprived lower limbs as external objects and, when not in their own wheelchair, also showed disownership of their intact upper limbs. To measure extrapersonal space perception, we used a novel, ad-hoc designed paradigm in which the participants were asked to observe a 3D scenario by means of immersive virtual reality and estimate the distance of a flag positioned on a ramp. In healthy subjects, errors in estimation increased as the distance increased, suggesting that they mentally represent the physical distance. The same occurred with the SCI participants, but only when they were in their own wheelchair. The results demonstrate for the first time that tool-embodiment modifies extrapersonal space estimations.

scholarly journals A new conceptual framework for the integrated neural control of locomotor and sympathetic function: implications for exercise after spinal cord injury

2018 ◽  
Vol 43 (11) ◽  
pp. 1140-1150 ◽  
Author(s):  
Kristine C. Cowley
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Conceptual Framework ◽  
Neural Control ◽  
Neural Circuitry ◽  
The Body ◽  
Sympathetic Function ◽  
Postural Changes ◽  
Cord Injury ◽  
New Research

All mammals, including humans, are designed to produce sustained locomotor movements. Many higher centres are involved in movement, but ultimately these centres act upon a core “rhythm-generating” network within the brainstem-spinal cord. In addition, endurance-based locomotor exercise requires sympathetic neural support to maintain homeostasis and to provide needed metabolic resources. This review focuses on the roles and integration of these 2 neural systems. Part I reviews the cardiovascular, thermoregulatory, and metabolic functions under spinal sympathetic control as revealed by spinal cord injury at different levels. Part II examines the integration between brainstem-spinal sympathetic pathways and the neural circuitry producing motor rhythms. In particular, the rostroventral medulla (RVM) contains the neural circuitry that (i) integrates heart rate, contractility, and blood flow in response to postural changes; (ii) initiates and maintains cardiovascular adaptations for exercise; (iii) provides direct descending innervation to preganglionic neurons innervating the adrenal glands, white adipose tissue, and tissues responsible for cooling the body; (iv) integrates descending sympathetic drive for energy substrate mobilization (lipolysis); and (v) is the relay for descending locomotor commands arising from higher brain centres. A unifying conceptual framework is presented, in which the RVM serves as the final descending supraspinal “exercise integration centre” linking the descending locomotor command signal with the metabolic and homeostatic support needed to produce prolonged rhythmic activities. The role and rationale for an ascending sympathetic and locomotor drive from the lower to upper limbs within this framework is presented. Examples of new research directions based on this unifying framework are discussed.

scholarly journals The Features of Attitude to the Body of Persons with Consequences of Cerebral Palsy and Spinal Cord Injury

2021 ◽  
Vol 10 (1) ◽  
pp. 180-205
Author(s):  
T.A. Meshkova ◽  
E.L. Gavrilova
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Cerebral Palsy ◽  
Negative Attitude ◽  
Disabled Persons ◽  
The Body ◽  
Body Parts ◽  
Body Appreciation ◽  
Cord Injury ◽  
Positive Statements

The features of attitude to the body of adults (from 21 to 65 years old; M=40,8) with consequences of cerebral palsy (13 persons) and spinal cord injury (15 persons) of varying severity and 40 persons (from 20 to 64 years old; M=35,3) without disabilities were studied. Two questionnaires with positive statements (Body Appreciation Scale and Functionality Appreciation Scale) were used, as well as a specially compiled questionnaire for assessing the negative attitude towards the body of persons with visible impairments and a non-verbal method for direct quantitative assessment of satisfaction with certain parts of the body. It was found that techniques aimed at direct assessment of body parts or assessment of negative attitude to the body reveal significant differences between healthy and disabled persons, indicating lower body assessments in persons with pathology, regardless of its type and severity, while questionnaires with positive statements can’t detect these differences. The level of positive attitude to the body in motor pathology is not lower than in the healthy persons. Analysis of the interaction of factors “type” vs “severity” of pathology reveals significant differences in the assessment of individual parts of the body (especially the legs and buttocks): persons with severe consequences of cerebral palsy rated their body areas higher than persons with severe forms of spinal trauma. The importance of the concept of a positive body image for the rehabilitation of persons with movement disorders is discussed.

scholarly journals Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

2021 ◽  
Vol 18 (8) ◽  
pp. 4219
Author(s):  
Magdalena Mackiewicz-Milewska ◽  
Małgorzata Cisowska-Adamiak ◽  
Katarzyna Sakwińska ◽  
Iwona Szymkuć-Bukowska ◽  
Iwona Głowacka-Mrotek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Heterotopic Ossification ◽  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
University Hospital ◽  
Pain Sensation ◽  
Vein Thrombosis ◽  
Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

scholarly journals Bone changes in the lower limbs from participation in an FES rowing exercise program implemented within two years after traumatic spinal cord injury

2018 ◽  
Vol 43 (3) ◽  
pp. 306-314 ◽  
Author(s):  
Rebecca L. Lambach ◽  
Nicole E. Stafford ◽  
Julie A. Kolesar ◽  
B. Jenny Kiratli ◽  
Graham H. Creasey ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Exercise Program ◽  
Lower Limbs ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Bone Changes

scholarly journals Intercostal, ilioinguinal, and iliohypogastric nerve transfers for lower limb reinnervation after spinal cord injury: an anatomical feasibility and experimental study

2019 ◽  
Vol 30 (2) ◽  
pp. 268-278 ◽  
Author(s):  
Ahmed A. Toreih ◽  
Asser A. Sallam ◽  
Cherif M. Ibrahim ◽  
Ahmed I. Maaty ◽  
Mohsen M. Hassan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Animal Studies ◽  
Femoral Nerve ◽  
Lower Limbs ◽  
Nerve Transfers ◽  
Promising Therapeutic Approach ◽  
Cord Injury ◽  
Significant Motor

OBJECTIVESpinal cord injury (SCI) has been investigated in various animal studies. One promising therapeutic approach involves the transfer of peripheral nerves originating above the level of injury into those originating below the level of injury. The purpose of the present study was to evaluate the feasibility of nerve transfers for reinnervation of lower limbs in patients suffering SCI to restore some hip and knee functions, enabling them to independently stand or even step forward with assistive devices and thus improve their quality of life.METHODSThe feasibility of transferring intercostal to gluteal nerves and the ilioinguinal and iliohypogastric nerves to femoral nerves was assessed in 5 cadavers. Then, lumbar cord hemitransection was performed below L1 in 20 dogs, followed by transfer of the 10th, 11th, and 12th intercostal and subcostal nerves to gluteal nerves and the ilioinguinal and iliohypogastric nerves to the femoral nerve in only 10 dogs (NT group). At 6 months, clinical and electrophysiological evaluations of the recipient nerves and their motor targets were performed.RESULTSThe donor nerves had sufficient length to reach the recipient nerves in a tension-free manner. At 6 months postoperatively, the mean conduction velocity of gluteal and femoral nerves, respectively, increased to 96.1% and 92.8% of the velocity in controls, and there was significant motor recovery of the quadriceps femoris and glutei.CONCLUSIONSIntercostal, ilioinguinal, and iliohypogastric nerves are suitable donors to transfer to the gluteal and femoral nerves after SCI to restore some hip and knee motor functions.

Sign in / Sign up

Export Citation Format

Share Document