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.

scholarly journals Development of a Rehabilitation Game for Individuals With Spinal Cord Injury Using a User-Centered Design Process

2018 ◽  
Author(s):  
Stuart R. Fairhurst ◽  
Logan C. McCool ◽  
Kristin M. Scheel ◽  
Crystal L. Stien ◽  
Charlotte M. Brenteson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Video Game ◽  
Perceived Exertion ◽  
Interactive Video ◽  
Spinal Cord Injuries ◽  
Lower Limbs ◽  
User Centered Design ◽  
Cord Injury ◽  
Interactive Video Game

The use of video games during exercise, exergaming, has been shown to increase energy expenditure without increasing perceived exertion [1]. This suggests that exergaming may be an effective way to engage a patient during rehabilitation and increase adherence to a rehabilitation regime. Existing exergame systems are designed with able bodied users in mind and often combine hand controlled game play while using lower limbs for aerobic exertion, making current systems inaccessible to individuals with spinal cord injuries and others without lower limb function. Our earlier work on increasing exercise accessibility includes developing an ergometer for supine use for patients who have recently had a flap procedure [2]. The goal of the present project was to create an engaging, interactive video game designed for use during arm ergometry by individuals with spinal cord injury (SCI) in either the supine or seated position.

scholarly journals A Histopathological Study of Ischemic and Compressive Paraplegia in Dogs

2017 ◽  
Vol 61 (2) ◽  
pp. 27-34
Author(s):  
I. Šulla ◽  
V. Balik ◽  
D. Maženský ◽  
V. Danielisová
Keyword(s):  
Spinal Cord ◽  
Grey Matter ◽  
Spinal Cord Injuries ◽  
Staining Method ◽  
Cord Compression ◽  
Histopathological Study ◽  
Injury Mechanisms ◽  
Cord Injury ◽  
The Central Nervous System ◽  
Secondary Spinal Cord Injury

AbstractIt is well known that neuronal death, clinically manifested as paresis or plegia, is the end result of many pathological events affecting the central nervous system. However, several aspects of pathophysiological mechanisms involved in the development of tetra- or paraplegia caused by spinal cord traumatic or ischemic damage are only insufficiently understood and their histopathological manifestations remain poorly documented. That is why the authors decided to report on light-microscopic changes observed in 30 μm thick spinal cord sections cut from L3-S1 segments processed by the Nauta staining method in a group of 6 dogs with ischemic paraplegia induced by 30 min of a high thoracic aorta occlusion, and in a different group of 6 dogs with traumatic paraplegia induced by 5 min spinal cord compression with 200 g metallic rod. Both experimental groups (ischemic and compression) of spinal cord injuries (SCI) comprised the same number of mongrel dogs of both sexes, weighing 18-25 kg. In addition, each of the experimental groups had 3 normal dogs that served as controls. All experimental procedures were accomplished under general anaesthesia induced by pentobarbital and maintained by a mixture of halothane and oxygen. Following the 72 hour survival period, all 18 animals were euthanized by transcardial perfusion with 3,000 ml of saline and fixed by 3,000 ml of 10 % neutral formaldehyde during deep pentobarbital anaesthesia. The histopathological manifestation of neural tissue damage caused by ischemia or compression was similar. The light-microscopic images in both groups were characterised by argyrophilia and the swelling of grey matter neurons. However, in the dogs with traumatic SCIs, the changes only reached about 750 μm cranially and caudally from the necrotic epicentre. These findings indicated that the events taking part in secondary spinal cord injury mechanisms are similar in both, ischemic as well as in traumatic SCI.

Introduction to the Nervous System

2017 ◽  
Author(s):  
Peggy Mason
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
The Body ◽  
Conscious Awareness ◽  
Sensory Stimuli ◽  
System P ◽  
Brainstem Stroke ◽  
Primary Deficit ◽  
The Central Nervous System ◽  
The Brain

The primary regions and principal functions of the central nervous system are introduced through the story of Jean-Dominique Bauby who became locked in after suffering a brainstem stroke. Bauby blinked out his story of locked-in syndrome one letter at a time. The primary deficit of locked-in syndrome is in voluntary movement because pathways from the brain to motoneurons in the brainstem and spinal cord are interrupted. Perception is also disturbed as pathways responsible for transforming sensory stimuli into conscious awareness are interrupted as they ascend through the brainstem into the forebrain. Homeostasis, through which the brain keeps the body alive, is also adversely affected in locked-in syndrome because it depends on the brain, spinal cord and autonomic nervous system. Abstract functions such as memory, language, and emotion depend fully on the forebrain and are intact in locked-in syndrome, as clearly evidenced by Bauby’s eloquent words.

Why and How Do We Hurt?

2002 ◽  
Author(s):  
Daniel J. Wallace ◽  
Janice Brock Wallace
Keyword(s):  
Spinal Cord ◽  
Nervous System ◽  
Clinical Situation ◽  
The Body ◽  
Sensory Pathways ◽  
System P ◽  
Chronic Pain Patients ◽  
The Central Nervous System ◽  
Pain Patients ◽  
The Brain

A fibromyalgia patient frequently complains of pain. The pain of fibromyalgia is different from that of a headache, stomach cramp, toothache, or swollen joint. It has been described as a type of stiffness or aching, often associated with spasm. Unlike the other pains mentioned above, fibromyalgia pain responds poorly to aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin). In fact, studies have suggested that even narcotics such as morphine are minimally beneficial in ameliorating fibromyalgia pain. Why is it that fibromyalgia patients can take codeine, Darvon, Vicodin, or even Demerol for musculoskeletal aches and have only a slight response? What produces “pain without purpose”? In this chapter, we’ll explore what makes fibromyalgia a pain amplification syndrome. Why does the patient hurt in places where there was often no injury and all laboratory tests are normal? What creates what doctors call allodynia, or a clinical situation that results in pain from a stimulus (such as light touch) that normally should not be painful? Fibromyalgia is a form of chronic, widespread allodynia, as well as sustained hyperalgesia, or greater sensitivity than would be expected to an adverse stimulus. The nervous system consists of several components. The brain and spinal cord comprise the central nervous system. Nerves leaving the spinal cord that tell us to move our arms or legs are part of the “motor” aspects of the peripheral nervous system. Additionally, all sorts of information about touch, taste, chemicals, and pressure are relayed through “sensory” pathways back to the spinal cord, where they are processed and sent up to the brain for a response. The autonomic nervous system consists of specialized peripheral nerves. Fibromyalgia is a disorder characterized by an inappropriate neuromuscular reaction that leads to chronic pain. Patients with fibromyalgia usually react normally to acute pain. Our current concepts of the way the body responds to chronic painful stimuli stem from the gate theory, first proposed by Ronald Melzack and Patrick Wall in 1965. Nerve “wires” go from the periphery to the dorsal horn of the spinal cord. These wires are modulated by feedback loops within the nervous system.

Identification of Low Torque Step Sizes for the Design of a Single-Channel Muscle-Powered Hybrid Orthosis for People With Spinal Cord Injury

2020 ◽  
Author(s):  
Yusra Farhat Ullah ◽  
William K. Durfee
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Gait Cycle ◽  
Quadriceps Femoris ◽  
Muscle Group ◽  
Lower Limbs ◽  
Quadriceps Femoris Muscle ◽  
Cord Injury ◽  
The Brain ◽  
Femoris Muscle

Abstract In paraplegia due to complete or incomplete spinal cord injury, the connection from the brain to muscles in the lower limbs is severed but the muscles that act on signals from the brain to produce limb movement remain functional. Functional electrical stimulation (FES), which is the application of electric potential across a muscle group to artificially cause the muscle to contract, is a method that can be used alone or in conjunction with an orthosis to produce a gait cycle. Such FES based walking machines or devices have been studied and designed for several decades. However, their application in everyday exercise is limited by several factors, one of which is the rapid onset of muscle fatigue produced in the stimulated muscle. In this work, simulations were conducted in Simscape Multibody to lay the groundwork for the design of a next-generation FES based walking machine powered by the quadriceps femoris muscle group of each limb. The stimulation of the quadriceps femoris muscle causes the knee to extend while some energy is stored by the orthosis, which uses the stored energy to complete the gait cycle. In this study, we have analyzed the power requirements of each step in the hybrid FES-orthosis gait cycle for different stride lengths. These requirements can help identify small step sizes to reduce the power required from the stimulated muscle.

The effect of undernutrition on the postnatal development of the brain and cord in pigs

1967 ◽  
Vol 166 (1005) ◽  
pp. 396-407 ◽  
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Brain Stem ◽  
The Body ◽  
Chronological Age ◽  
Absolute Amount ◽  
The Central Nervous System ◽  
One Year ◽  
The Brain

Sucking pigs about 2 weeks old were held back by undernutrition so that they weighed only 5 to 6 kg when they were a year of age. The brain and cord developed during this time to the size to be expected in a normal pig about 10 weeks old but, although they remained immature for their chronological age, the effect on the various constituents was not uniform. The accumulation of cholesterol was less retarded than that of DNA.P or the increase in brain weight. During rehabilitation on a highly satisfactory diet the final body w eight reached at 3 1/2 years was 80 % of that to be expected in an adult pig and was equivalent only to that of a normal pig two years old. The central nervous system grew to the appropriate size for the body. The percentage of cholesterol in the central nervous system rose during rehabilitation, but, particularly in the forebrain, brain stem and spinal cord, remained subnormal for the chronological age. The deficiency of DNA- P in the rehabilitated brain was even greater, and the absolute amount finally corresponded to that found in the brain of a norm alanimal only one year of age.

Plasticity in Sublesionally Located Neurons Following Spinal Cord Injury

2007 ◽  
Vol 98 (5) ◽  
pp. 2497-2500 ◽  
Author(s):  
Nicolas P. Lapointe ◽  
Roth-Visal Ung ◽  
Pierre A. Guertin
Keyword(s):  
Spinal Cord ◽  
Neurotrophic Factors ◽  
Spinal Cord Injuries ◽  
Current Knowledge ◽  
Tnf Alpha ◽  
Cord Injury ◽  
Cellular Modifications ◽  
Injured Patients ◽  
Spinal Cord Injured ◽  
The Brain

Neuronal plasticity has been traditionally associated with learning and memory processes in the hippocampal regions of the brain. It is now generally accepted that plasticity phenomena are also associated with other kinds of cellular changes and modifications occurring in all areas of the CNS after injury or intense neuronal activity. For instance, spinal cord injuries have been associated with a series of cellular modifications and adaptations taking place distally in sublesional areas. Some of these modifications include changes in the expression of immediate early genes (e.g., c-fos and nor-1), TNF-alpha, preprodynorphin, neurotrophic factors (e.g., BDNF and NT-3), and several subtypes of transmembranal receptors (e.g., 5-HT1A and 5-HT2A). This review constitutes an update of the current knowledge regarding this broadly defined plasticity phenomenon that occurs spontaneously or can be modulated by training in sublesional segments of the spinal cord. Spinal cord plasticity is an increasingly popular field of research, believed by many as being a complex phenomenon that may contribute to the development of innovative therapeutics and rehabilitative approaches for spinal cord injured patients.

Active physiological conservative management in traumatic spinal cord injuries – an evidence-based approach

Trauma ◽  
2017 ◽  
Vol 19 (1_suppl) ◽  
pp. 10-22 ◽  
Author(s):  
W El Masri ◽  
Naveen Kumar
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Conservative Management ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Surgical Decompression ◽  
The Body ◽  
Prognostic Indicators ◽  
Number Of Patients ◽  
Cord Injury

The management of the traumatic spinal cord injury remains controversial. Guttmann demonstrated that with simultaneous attention to all medical and non-medical effects of the spinal cord injury, a significant number of patients recovered motor and sensory functions to ambulate and the majority were pain-free following conservative management. Active physiological conservative management of the spinal injury requires simultaneous scrupulous care of the injured spine together with; the multisystem neurogenic effects of the spinal cord injury on the respiratory, cardiovascular, urinary, gastrointestinal, dermatological, sexual and reproductive functions; the management of the associated psychological effects of paralysis from the early hours or days of injury as well as; the physical rehabilitation and modification of the environment. To date, there is no evidence to suggest that the surgical decompression and/or stabilisation of the neurologically impaired spinal cord injury patient is advantageous. This article considers the debates and evidence of surgical management including the effects of timing of the surgical decompression. Also addressed are the factors influencing decisions on management, prognostic indicators of recovery and natural history of complete and incomplete cord injuries. Traumatic biomechanical instability of the spine, physiological instability of the spinal cord, traumatic spinal canal encroachment and traumatic cord compression are also discussed. Early mobilisation, indications for surgery at the RJAH and economic considerations of spinal cord injuries are presented. The ultimate goals of the active physiological conservative management are to ensure maximum neurological recovery and independence, a pain-free and flexible spine, safe and convenient functioning of the various systems of the body with minimal inconvenience to patients and the prevention of complications.

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.

5. Reacting and thinking

2021 ◽  
pp. 76-88
Author(s):  
Jamie A. Davies
Keyword(s):  
Spinal Cord ◽  
Central Nervous System ◽  
Nervous System ◽  
Learning And Memory ◽  
Cell Types ◽  
The Body ◽  
The Central Nervous System ◽  
The Brain ◽  
Vast Network

This chapter assesses the nervous system. In the trunk of the body and the neck, the central nervous system (CNS) is called the spinal cord; in the head, it is called the brain. The CNS is dominated by two cell types: neurons and glia. The neurons form a vast network in which information is split, combined, and somehow processed. Examples of this processing include reflex arcs, the ‘circuitry’ that detects features such as edges in images coming from the eyes, and simple types of learning and memory. However, most other things in the brain, especially thinking and feeling, are not yet understood at all well.

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