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Published on: April 11, 2025
Brain Morphology in Subacute Spinal Cord Injury: Insights Into Functional Recovery Across Brain Networks
Lorenzo Diana1, Jothini Sritharan1,2, Nicola Brunello1,3
1Swiss Paraplegic Research, Nottwil, Switzerland.
Brain and Behavior
|July 24, 2026
Summary
Brain morphometry did not improve predictions of functional recovery after spinal cord injury (SCI). However, specific cortical regions showed associations with independence, offering insights for future research.
Area of Science:
- Neuroscience
- Radiology
- Rehabilitation Medicine
Background:
- Spinal cord injury (SCI) causes significant brain reorganization, impacting sensorimotor and other areas.
- The predictive value of whole-brain morphometry for functional recovery in SCI patients, alongside clinical factors, is not well understood.
Purpose of the Study:
- To investigate whether whole-brain cortical gray matter volumes can enhance the prediction of functional independence in SCI patients.
- To compare the predictive performance of a clinical-only model versus a combined model integrating clinical data and brain morphometry.
Main Methods:
- Retrospective analysis of 79 individuals with SCI from the SwiSCI Inception Cohort.
- Brain MRI data acquired during inpatient rehabilitation were analyzed.
- Two cross-validated elastic-net regression models were used: one with clinical variables only, and another combining clinical variables with whole-brain gray matter volumes.
Main Results:
- Both models demonstrated comparable predictive performance for functional independence (Spinal Cord Independence Measure, SCIM-III) at discharge.
- The combined model identified distributed cortical regions, including associative parietal and primary sensorimotor areas, as relevant to functional independence.
- Some identified cortical regions correlated with subacute neurological severity, suggesting clinical relevance.
Conclusions:
- Brain morphometry did not offer incremental predictive value beyond established clinical variables for functional independence in this SCI sample.
- The study highlights specific cortical regions across sensorimotor and higher-order networks associated with functional recovery post-SCI.
- These findings provide insights into neural correlates of SCI recovery and suggest potential targets for future neuroimaging research.
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