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Brain Activation Evoked by Motor Imagery in Pediatric Patients with Complete Spinal Cord Injury
L Wang1,2, W M Zheng1,2, T F Liang3
1From the Department of Radiology and Nuclear Medicine (L.W., W.M.Z., Y.H.Y., B.N.Y., X.C., J.L., N.C.), Xuanwu Hospital, Capital Medical University, Beijing, China.
Insights
Motor imagery activates preserved brain networks in children with complete spinal cord injury, showing higher sensorimotor activation. This suggests potential for motor imagery training in pediatric rehabilitation.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Pediatric Neurology
Background:
- Pediatric complete spinal cord injury lacks effective treatments.
- Motor imagery is a potential alternative to physical therapy for non-voluntary movement.
- Understanding the mechanism of motor imagery in pediatric SCI is crucial.
Purpose of the Study:
- To investigate the brain activation patterns during motor imagery in pediatric patients with complete spinal cord injury.
- To compare motor imagery activation between pediatric SCI patients and healthy children.
- To explore the potential of motor imagery as a rehabilitation strategy.
Main Methods:
- Functional magnetic resonance imaging (fMRI) was used to scan 26 pediatric patients with complete spinal cord injury and 26 healthy controls.
- Participants performed motor imagery tasks; healthy controls also underwent motor execution scans.
- Brain activation was compared between motor imagery and execution in controls, and between groups during motor imagery.
Main Results:
- Motor imagery in healthy controls showed distinct activation patterns compared to motor execution.
- Both groups activated common motor imagery networks, including the supplementary motor area and inferior parietal lobule.
- Pediatric SCI patients exhibited higher activation in sensorimotor regions during motor imagery than healthy controls, even exceeding healthy controls' motor execution activation.
Conclusions:
- The motor imagery network is partially preserved and can be activated in pediatric complete spinal cord injury.
- Elevated activation in sensorimotor regions during motor imagery suggests compensatory mechanisms.
- These findings support motor imagery training as a viable therapeutic approach for pediatric spinal cord injury rehabilitation.
Background And Purpose:
Currently, there is no effective treatment for pediatric patients with complete spinal cord injury. Motor imagery has been proposed as an alternative to physical training for patients who are unable to move voluntarily. Our aim was to reveal the potential mechanism of motor imagery in the rehabilitation of pediatric complete spinal cord injury.
Materials And Methods:
Twenty-six pediatric patients with complete spinal cord injury and 26 age- and sex-matched healthy children as healthy controls were recruited. All participants underwent the motor imagery task-related fMRI scans, and additional motor execution scans were performed only on healthy controls. First, we compared the brain-activation patterns between motor imagery and motor execution in healthy controls. Then, we compared the brain activation of motor imagery between the 2 groups and compared the brain activation of motor imagery in pediatric patients with complete spinal cord injury and that of motor execution in healthy controls.
Results:
In healthy controls, compared with motor execution, motor imagery showed increased activation in the left inferior parietal lobule and decreased activation in the left supplementary motor area, paracentral lobule, middle cingulate cortex, and right insula. In addition, our results revealed that the 2 groups both activated the bilateral supplementary motor area, middle cingulate cortex and left inferior parietal lobule, and supramarginal gyrus during motor imagery. Compared with healthy controls, higher activation in the bilateral paracentral lobule, supplementary motor area, putamen, and cerebellar lobules III-V was detected in pediatric complete spinal cord injury during motor imagery, and the activation of these regions was even higher than that of healthy controls during motor execution.
Conclusions:
Our study demonstrated that part of the motor imagery network was functionally preserved in pediatric complete spinal cord injury and could be activated through motor imagery. In addition, higher-level activation in sensorimotor-related regions was also found in pediatric complete spinal cord injury during motor imagery. Our findings may provide a theoretic basis for the application of motor imagery training in pediatric complete spinal cord injury.
