Cortical Brain Activation During Robot-Assisted Gait in Humans With Acute and Chronic Spinal Cord Injury: A...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Spinal cord injury (SCI) treatments often assume intact brain motor functions.
• Understanding residual neurological function is crucial for effective SCI rehabilitation.

Purpose of the Study:

• To analyze brain activity during assisted robotic gait in individuals with SCI.
• To compare neurological function based on gait phase, time since injury, injury level, and ASIA impairment scale.

Main Methods:

• Functional near-infrared spectroscopy (fNIRS) was used to measure hemodynamic responses.
• 23 individuals with SCI (acute/chronic, paraplegic/tetraplegic, ASIA C/D) performed assisted robotic gait (Lokomat).
• Brain activity was analyzed in the supplementary motor area (SMA), dorsolateral prefrontal cortex (DLPFC), primary motor cortex (M1), and primary somatosensory cortex (S1).

Main Results:

• Higher brain activity (oxyhemoglobin) was observed in SMA and M1 during robotic gait compared to rest.
• The chronic SCI group showed higher M1 activity than the acute group.
• Individuals with paraplegia exhibited greater M1 activity than those with tetraplegia.

Conclusions:

• Brain motor cortex areas demonstrate significant plasticity and adaptability post-SCI, even in chronic stages.
• Robotic-assisted walking tasks reveal important residual neurological functions in SCI patients.
• Assessing brain motor cortex activity during functional tasks is vital for SCI recovery strategies.