Cortical activation during visual illusory walking in persons with spinal cord injury: A pilot study

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Study determined the location of cortical activation during a visual illusion walking paradigm, a recently proposed treatment for spinal cord injury (SCI)-related neuropathic pain, in people with SCI compared with able-bodied controls. Three people with paraplegia and 5 able-bodied participants were included in this study. The walking stimuli consisted of a video of an actor walking along a path. The control stimuli consisted of the same actor propelling a manual wheelchair along the same path for the same length of time. Prior to the presentation of the stimuli during scanning, participants were instructed to imagine that they themselves were performing the movements of the actor, but without actual movement of limbs. They were instructed to gaze at a fixation point during resting state scanning. Cortical activation as measured by the blood oxygenation level-dependent method of functional magnetic resonance imaging. 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 they showed activation in the frontal and premotor areas. Results suggest that treatment modalities for SCI-related neuropathic pain that are based on sensory input paradigms (e.g., virtual walking, visual illusory walking) may work by targeting the somatosensory cortex, an area that has been previously found to functionally reorganize after SCI.

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