Chronic spinal cord injury is associated with morphometric brain changes in functional networks beyond the...

Spinal cord injury (SCI) leads to motor and sensory deficits, triggering widespread neurodegeneration across the central nervous system. While sensorimotor brain changes have been widely studied, growing evidence suggests that SCI also affects regions involved in cognition, emotion, and pain regulation-domains frequently altered in the chronic stage. However, morphological alterations in higher-order brain networks remain poorly characterized. To address this gap, we investigated structural brain changes in chronic SCI using voxel-based and surface-based morphometry, focusing on large-scale functional networks.

We retrospectively analyzed high-resolution T1-weighted MRI data from 45 individuals with chronic traumatic SCI and 45 matched controls. Gray matter volume and cortical thickness were estimated with CAT12. Group comparisons and associations with clinical measures-including time since injury, sensorimotor impairment, and chronic pain-were assessed using whole-brain and region-based morphometry mapped to the Schaefer functional atlas.

Compared to controls, SCI participants showed reduced volume in the precentral gyrus (sensorimotor network), increased volume in the right precuneus (executive control network) and reduced cortical thickness in the left temporal pole (limbic network). Longer time since injury and greater sensorimotor deficits were associated with atrophy in sensorimotor, temporo-parietal, and prefrontal regions spanning executive, attentional, default mode, and salience networks. Additionally, chronic pain was linked to atrophy in the sensorimotor cortex, basal ganglia, and cerebellum.

These findings suggest that chronic SCI is associated with widespread morphometric changes beyond the sensorimotor system. Such alterations may underlie cognitive, emotional, and pain-related symptoms, and represent potential biomarkers of secondary health complications following SCI.