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 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 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 Rethinking the Body in the Brain after Spinal Cord Injury

2022 ◽  
Vol 11 (2) ◽  
pp. 388
Author(s):  
Erik Leemhuis ◽  
Valentina Giuffrida ◽  
Maria Luisa De Martino ◽  
Giuseppe Forte ◽  
Anna Pecchinenda ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spatial Organization ◽  
Spinal Cord Injuries ◽  
The Body ◽  
Lower Limbs ◽  
Body Regions ◽  
Cord Injury ◽  
The Central Nervous System ◽  
Clinical Resource ◽  
The Brain

Spinal cord injuries (SCI) are disruptive neurological events that severly affect the body leading to the interruption of sensorimotor and autonomic pathways. Recent research highlighted SCI-related alterations extend beyond than the expected network, involving most of the central nervous system and goes far beyond primary sensorimotor cortices. The present perspective offers an alternative, useful way to interpret conflicting findings by focusing on the deafferented and deefferented body as the central object of interest. After an introduction to the main processes involved in reorganization according to SCI, we will focus separately on the body regions of the head, upper limbs, and lower limbs in complete, incomplete, and deafferent SCI participants. On one hand, the imprinting of the body’s spatial organization is entrenched in the brain such that its representation likely lasts for the entire lifetime of patients, independent of the severity of the SCI. However, neural activity is extremely adaptable, even over short time scales, and is modulated by changing conditions or different compensative strategies. Therefore, a better understanding of both aspects is an invaluable clinical resource for rehabilitation and the successful use of modern robotic technologies.

Visuo-motor and interoceptive influences on peripersonal space representation following spinal cord injury.

2019 ◽  
Author(s):  
Michele Scandola ◽  
Salvatore Maria Aglioti ◽  
Carlo Alberto Arcangeli ◽  
Renato Avesani ◽  
Silvio Ionta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Peripersonal Space ◽  
Space Representation ◽  
Body Parts ◽  
Short Term ◽  
Virtual Reality Technology ◽  
Passive Motion ◽  
Cord Injury ◽  
Interoceptive Sensitivity

Peripersonal space (PPS) representation is affected by information coming from body, as demonstrated by patients with spinal cord injury (SCI) in whom a body-brain disconnection leads to deafferentation and deefferentation of the below-lesion body parts. In particular, in paraplegic individuals whose lower limb sensory-motor functions are impaired or completely lost, the representation of PPS around the feet is reduced. However, passive motion can have short-term restorative effects. What remains unclear is the mechanisms underlying this recovery and in particular the contribution of visual and motor feedback and of interoception. Using virtual reality technology, we dissociated the motor and visual feedback during passive motion in paraplegics with complete and incomplete lesions and in healthy controls.Results show that in the case of paraplegics (even those with complete lesions), the presence of motor feedback is necessary for the recovery of PPS representation, both when the motor feedback is congruent and incongruent with the visual one. In contrast, visuo-motor incongruence leads to inhibition of the PPS representation in controls.There were no differences in sympathetic responses between the three groups. Nevertheless, in individuals with incomplete lesions, greater interoceptive sensitivity is associated with better representation of PPS around the feet in visuo-motor incongruent conditions.These results shed new light on the modulation of PPS representation, and demonstrates the importance of residual motor feedback and its integration with other bodily information in maintaining space representation.

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

2019 ◽  
Vol 237 (10) ◽  
pp. 2621-2632 ◽  
Author(s):  
Michele Scandola ◽  
Rossella Togni ◽  
Gaetano Tieri ◽  
Renato Avesani ◽  
Massimo Brambilla ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Space Perception ◽  
Extrapersonal Space ◽  
Cord Injury

scholarly journals Acute-onset paraplegia as an unexpected complication under general anesthesia in supine position during abdominal endovascular aneurysm repair: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Atsushi Morio ◽  
Hirotsugu Miyoshi ◽  
Noboru Saeki ◽  
Yukari Toyota ◽  
Yasuo M. Tsutsumi
Keyword(s):  
Spinal Cord ◽  
General Anesthesia ◽  
Supine Position ◽  
Spinal Cord Ischemia ◽  
Endovascular Aneurysm Repair ◽  
Acute Onset ◽  
Lower Limbs ◽  
Canal Stenosis ◽  
Cord Injury ◽  
Aneurysm Repair

Abstract Background Acute onset paraplegia after endovascular aneurysm repair (EVAR) is a rare but well-known complication. We here show a 79-year-old woman with paraplegia caused by static and dynamic spinal cord insult not by ischemia after EVAR. Case presentation The patient underwent EVAR for abdominal aortic aneurism under general anesthesia in the supine position. She had a medical history of lumbar canal stenosis. After the surgery, we recognized severe paraplegia and sensory disorder of lower limbs. Although the possibility of spinal cord ischemia was considered at that time, postoperative magnetic resonance imaging (MRI) revealed burst fracture of vertebra and compressed spinal cord. Conclusions Patients with spinal canal stenosis can cause extrinsic spinal cord injury even with weak external forces. Thus, even after EVAR, it is important to consider extrinsic factors as the cause of paraplegia.

scholarly journals Disseminated Cryptococcosis revealed by transverse myelitis in Immunocompetent patient: a case report and review of the literature

BMC Neurology ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fangfang Qu ◽  
Zhenzhen Qu ◽  
Yingqian Lv ◽  
Bo Song ◽  
Bailin Wu
Keyword(s):  
Spinal Cord ◽  
Amphotericin B ◽  
Transverse Myelitis ◽  
Immunocompetent Patient ◽  
Lower Limbs ◽  
Coxsackie Virus ◽  
Gadolinium Contrast ◽  
Thoracic Spinal Cord ◽  
Thoracic Spinal ◽  
Cord Injury

Abstract Background Transverse myelitis (TM) is due to inflammatory spinal cord injury with bilateral neurologic involvement, which is sensory, motor, or autonomic in nature. It may be associated with autoimmune disease, vaccination, intoxication and infections. The most common infection cause of TM is Coxsackie virus and Mycoplasma pneumoniae. The cryptococcosis is rare. We present the case of disseminated cryptococcosis revealed by transverse myelitis in an immunocompetent 55-year-old male patient. The literature review is also stated. Case presentation The 55-year-old man suffered from gradual numbness, weakness in both lower limbs and finally paralyzed in the bed. The thoracic spine Computed tomography (CT) was normal, but multiple nodules in the lung were accidentally discovered. Thoracic Magnetic Resonance Imaging (MRI) showed diffused thoracic spinal cord thickening and extensively intramedullary T2 hyper intensity areas. Gadolinium contrast enhanced T1WI showed an intramedullary circle-enhanced nodule at 9th thoracic level. Diagnosis was made by histological examination of the bilateral lung biopsy. The patient was treated successfully with systemic amphotericin B liposome and fluconazole and intrathecal dexamethasone and amphotericin B liposome. Conclusions This is a patient with disseminated cryptococcosis involving the lung, spinal cord and adrenal glands, which is rare in the absence of immunodeficiency.

The Role of Hand Size in the Fake-Hand Illusion Paradigm

Perception ◽  
10.1068/p5853 ◽  
2007 ◽  
Vol 36 (10) ◽  
pp. 1547-1554 ◽  
Author(s):  
Francesco Pavani ◽  
Massimiliano Zampini
Keyword(s):  
Body Image ◽  
Body Schema ◽  
Body Representation ◽  
The Body ◽  
Video Image ◽  
Body Parts ◽  
Statistical Correlations ◽  
Hand Size ◽  
Visible Hand

When a hand (either real or fake) is stimulated in synchrony with our own hand concealed from view, the felt position of our own hand can be biased toward the location of the seen hand. This intriguing phenomenon relies on the brain's ability to detect statistical correlations in the multisensory inputs (ie visual, tactile, and proprioceptive), but it is also modulated by the pre-existing representation of one's own body. Nonetheless, researchers appear to have accepted the assumption that the size of the seen hand does not matter for this illusion to occur. Here we used a real-time video image of the participant's own hand to elicit the illusion, but we varied the hand size in the video image so that the seen hand was either reduced, veridical, or enlarged in comparison to the participant's own hand. The results showed that visible-hand size modulated the illusion, which was present for veridical and enlarged images of the hand, but absent when the visible hand was reduced. These findings indicate that very specific aspects of our own body image (ie hand size) can constrain the multisensory modulation of the body schema highlighted by the fake-hand illusion paradigm. In addition, they suggest an asymmetric tendency to acknowledge enlarged (but not reduced) images of body parts within our body representation.

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.

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