Objective To determine the location of cortical activation during a visual illusion going for walks paradigm a recently proposed treatment for spinal cord injury (SCI)-related neuropathic pain in persons with SCI compared to Rabbit Polyclonal to RUFY1. able-bodied controls. by blood oxygenation-level dependent (BOLD) method of fMRI. Results During visually illusory walking there was significant activation in the somatosensory cortex among those with SCI. In contrast able-bodied participants showed little to no significant activation in this area but rather in the frontal and pre-motor areas. Conclusions Treatment modalities for SCI-related neuropathic pain that are based on sensory input paradigms such as virtual or visual illusory walking WZ4002 may work by focusing on somatosensory cortex an area that has been previously found to functionally reorganize following SCI. Keywords: spinal cord injuries neuropathic pain somatosensory cortex fMRI Intro Approximately 70% of individuals report pain following spinal cord injury (SCI).1 Neuropathic pain is one form of post-SCI pain that is experienced in a region of sensory disturbance around or below the zone of injury. SCI-related neuropathic pain is usually refractory with many individuals experiencing only moderate to minimal responsiveness to currently available treatments.2 It is for this reason that novel treatment approaches to address SCI-related neuropathic pain are now being explored with encouraging initial results. Novel treatments for SCI-related neuropathic pain are based on the assumption that cortical activity is definitely continually modulated by afferent intersensory processes.3 When disruptions with this cortical-afferent operating opinions system occur such as in amputation the brain can functionally reorganize – a trend thought to underlie the pain that is experienced.4 Reinstating sensory input via visual illusion (e.g. mirror package therapy for phantom limb pain) has been found to promote pain alleviation5 6 WZ4002 and moreover some sensory input paradigms have been shown to reverse the reorganization thought to underlie phantom pain.7 Similarly functional cortical reorganization in the somatosensory cortex has been linked to SCI and to a greater degree among those with SCI-related pain.8 Additionally existing evidence suggests that when individuals with SCI-related neuropathic pain are provided the visual illusion that they are walking the severity of their pain is reduced.9 10 If in fact SCI-related neuropathic pain is alleviated by reinstating sensory input through visual illusion walking paradigms then it remains to be understood how these treatments affect the cortical correlates of SCI-related neuropathic pain and perhaps reverse maladaptive functional reorganization. It has been demonstrated that mirror package therapy results in sensorimotor activation contralateral to the virtual hand supporting the theory that perception takes on a large part in sensorimotor cortical activity.11 Providing the visual illusion of going for walks may have a similar effect as mirror box therapy yet the cortical region of activation has not been characterized. Therefore the aim of this study was WZ4002 to determine the location of cortical activation during a visual illusory walking paradigm in individuals with SCI compared to able-bodied settings. We hypothesized the visual illusion of walking would activate the sensorimotor cortex in individuals with SCI and that the patterns of activation would be different than that of able-bodied participants. Methods Subjects Three WZ4002 individuals with SCI (2 male 1 female) who were non ambulatory manual wheelchair users were recruited from an outpatient rehabilitation center (Table 1). Additionally data from five able-bodied settings (2 male 3 female) were used for comparison. The study was authorized by the institution��s IRB and knowledgeable written consent was from all participants for all the procedures. Table 1 Age and injury characteristics of participants. MRI scanning and image processing Whole brain images were acquired using a Philips Achieva 3 Tesla MRI systema and the blood oxygenation-level dependent (BOLD) method of fMRI was used to measure switch in cerebral blood flow during presentation of each stimulus. A block design was used such that participants viewed independent 30-second blocks of fixation point (resting state) visual illusion of walking and visual illusion of wheelchair use. The stimuli were.