BACKGROUND AND PURPOSE:Supraspinal somatosensory pathways neuroplasticity critically influences sensory recovery after spinal cord injury (SCI) and offers promising neuromodulation targets. However, distinctions between complete SCI (CSCI) and incomplete SCI (ISCI) patients remain unclear. We aimed to delineate injury severity-dependent neuroplasticity patterns in somatosensory pathways, and provide mechanistic insights for developing targeted rehabilitation strategies. MATERIALS AND METHODS:Resting-state effective connectivity (EC) within supraspinal somatosensory pathways was analyzed using spectral dynamic causal modelling in 17 CSCI patients, 17 ISCI patients, and 37 healthy controls. The primary somatosensory cortex (S1), second somatosensory cortex (S2), thalamus (THA), insula (INS), cerebellar lobule VI (CB6) and primary motor cortex were employed as the regions of interest. A fully connected model was specified for each participant, and group-level differences in EC were assessed using parametric empirical Bayes. Connections with a posterior probability > 0.95 were considered significant. Additionally, correlation analyses were performed between significant EC and sensory scores. RESULTS:Both CSCI and ISCI groups exhibited impaired basic somatosensory conduction, including dysfunction from the THA to the S1 and dysregulation along the S1-S2-INS pathway. However, their specific connectivity patterns diverged. The CSCI group showed weakened self-inhibition within the THA and S1. The ISCI group exhibited stronger inhibitory EC from S2 to INS and from CB6 to S1. CONCLUSIONS:CSCI and ISCI patients predominantly exhibit decreased and increased EC within the supraspinal somatosensory pathways, respectively. The CSCI patients showed reduced THA/S1 self-inhibition, whereas ISCI patients exhibited strengthened S2-INS/CB6-S1 connectivity, possibly compensating for sensory deficits and suggesting neuromodulation targets for somatosensory recovery.

Dorsal root entry zone (DREZ) lesioning is an established neurosurgical procedure for treating refractory neuropathic pain (NP) after spinal cord injury (SCI). To identify preoperative neuroimaging biomarkers associated with surgical outcomes, we analyzed 24 SCI-NP participants who showed differential responses to DREZ lesioning. We hypothesized that preoperative alterations in white matter integrity, brain structure, and functional connectivity (FC), particularly within the descending pain modulatory system, would differ between participants with effective versus ineffective surgical outcomes. Based on the extent of postoperative pain relief, participants were classified into an effective group (EG) and an ineffective group (IG). Preoperative multimodal MRI was obtained, including diffusion tensor imaging (DTI), 3D high-resolution T1-weighted structural imaging (extending to the cervical 5 level), and resting-state functional data. Cervical level C2/C3 macrostructure parameters were measured employing the Jim 7.0 software. Tract-based spatial statistics was performed on DTI data, and voxel-based morphometry was carried out for structural images. For functional MRI data, regions showing significant structural alterations were used as seeds to compute FC. Compared to the EG, the IG exhibited increased mean diffusivity (MD) in the bilateral internal capsule and axial diffusivity (AD) in the right corticospinal tract, along with increased gray matter volume in the periaqueductal gray (PAG). Using the PAG as a seed, the IG showed reduced FC between the PAG and the left primary sensorimotor cortex. No significant differences between groups were found in spinal cord macrostructure. These findings demonstrate that participants with different outcomes exhibit distinct preoperative patterns of brain reorganization, particularly in the PAG and its sensorimotor connectivity. These findings suggest that preoperative multimodal MRI may help identify participants unlikely to benefit from DREZ lesioning, potentially guiding surgical candidacy and personalized treatment planning.

Pediatric spinal cord injury (SCI) induces extensive neuroplastic changes in the developing brain; however, the patterns of cortical remodeling associated with complete (CSCI) and incomplete (ICSCI) injuries remain poorly understood. In this study, high-resolution structural magnetic resonance imaging was used to assess cortical morphological alterations in 72 pediatric SCI patients (38 CSCI and 34 ICSCI) and 37 age-matched healthy controls (HCs). Key cortical metrics-including surface area, thickness, volume, and curvature-were analyzed to characterize injury-related reorganization. Significant group differences were identified across multiple cortical regions. Compared with HCs, both CSCI and ICSCI patients exhibited reduced surface area in the left primary somatosensory cortex (S1), with CSCI patients showing significantly greater surface area than ICSCI. In the left posterior cingulate cortex (PCC), surface area was significantly reduced in the CSCI group compared with ICSCI. Cortical thickness analysis revealed that both patient groups showed increased thickness in the bilateral superior and middle temporal regions, but decreased thickness in the left paracentral lobule, inferior insula, and right supramarginal gyrus (SMG). Notably, CSCI patients had significantly lower thickness in the right SMG than ICSCI patients. For cortical volume, both SCI groups exhibited increased volume in the bilateral transverse frontopolar cortex, with the CSCI group showing significantly greater volume in the right hemisphere compared with ICSCI. No significant differences were found in cortical curvature across groups. Correlation analyses showed that surface area in the left PCC was positively associated with sensory scores across all patients. In ICSCI patients, right frontopolar volume positively correlated with both motor and sensory scores. Receiver operating characteristic analysis demonstrated that surface area (left S1, PCC), cortical thickness (right SMG), and cortical volume (right transverse frontopolar cortex) could differentiate CSCI from ICSCI, with a combined classification model achieving an area under the curve of 0.7980. Our findings indicated that CSCI and ICSCI are associated with distinct patterns of cortical reorganization in regions related to sensory processing and affective-cognitive integration. These results highlight the diagnostic potential of multidimensional cortical morphometry and support its relevance in guiding individualized, neuromodulation-based rehabilitation strategies in pediatric SCI.

Background:This study evaluated the prognostic value of pulmonary transit time (PTT) and myocardial strain in ST-elevation myocardial infarction (STEMI) patients stratified by the Canadian Cardiovascular Society (CCS) classification. Material and methods:A total of 521 STEMI patients underwent 3.0-T cardiac magnetic resonance (CMR) imaging between January 2017 and December 2025. PTT was measured as the number of cardiac cycles for contrast to travel from the right to left ventricle during first-pass perfusion. Global myocardial strain (longitudinal, circumferential, radial) was assessed via CMR feature tracking. Cox regression analyses were used to evaluate associations of PTT, normalized PTT (nPTT), wall motion score index (WMSI), and global longitudinal strain (GLS) with major adverse cardiac events (MACE: death, re-infarction, heart failure). Results:Of 409 analyzed patients, higher CCS stages were associated with prolonged PTT, greater myocardial injury, and elevated pulmonary blood volume index (PBVI), WMSI, and microvascular obstruction (MVO). Over six months, myocardial strain improved in CCS1-3, while GLS worsened in CCS4. Multivariable analysis identified PBVI, nPTT, PTT, GLS, and WMSI as independent predictors of MACE. Kaplan-Meier analysis showed significantly lower MACE-free survival in CCS4 patients (P < 0.01). Conclusion:Elevated PTT correlates with severe myocardial injury and adverse outcomes. PBVI, nPTT, PTT, GLS, and WMSI are independent prognostic indicators, providing valuable risk stratification across CCS stages.

Cerebral asymmetry is a core principle of human brain organization, showing dynamic changes across the lifespan and alterations in brain disorders. However, it remains unclear whether lifespan trajectories of asymmetry differ across populations. We compared lifespan structural asymmetry normative charts of 221 cerebral imaging phenotypes from 43,037 Chinese and 56,339 Western participants aged 0–100 years. The two populations showed distinct lifespan asymmetry patterns in 26.2% of the phenotypes. Chinese-minus-Western asymmetry difference curves displayed distinct patterns across brain phenotypes: rightward (45.7%), leftward (26.2%), rightward-to-leftward (11.8%), leftward-to-rightward (10.0%), and unclassified (6.3%). Population-matched normative models outperformed population-unmatched normative models in capturing normal asymmetry variability among healthy individuals and in detecting abnormal asymmetry deviations in patients with Alzheimer’s disease, mild cognitive impairment, schizophrenia, and major depressive disorder. These findings indicate that population mismatch can bias chart-based individual-level asymmetry assessment and underscore the need for population-representative brain asymmetry normative charts.

To study the brain functional alterations of children after spinal cord injury (SCI) and explore their changes after motor imagery training (MIT), revealing brain functional reorganizations in pediatric SCI and finding possible neural mechanisms of MIT. Thirty pediatric SCI patients and 30 age- and gender-matched healthy controls (HCs) were recruited. Brain resting-state functional MRI images of all subjects were obtained using a 3.0 Tesla MRI system. Subsequently, eight of the patients completed a 4-week MIT, and then functional MRI scans were conducted once again. Then two-sample t-tests were used to compare amplitude of low frequency (ALFF), fractional ALFF (fALFF), regional homogeneity (ReHo) between groups at baseline, and paired t-tests were used to investigate the changes in ALFF, fALFF and ReHo of patients before and after the treatment. Compared with HCs, the patients showed decreased ALFF and/or ReHo in bilateral postcentral gyrus (S1) and right orbitofrontal cortex, while increased ALFF and/or ReHo in the bilateral cerebellar lobules IV-VI, thalamus, left middle cingulate cortex (MCC), cerebellar Crus II, and right parahippocampal gyrus, caudate nucleus, middle temporal gyrus (MTG). Compared with those before MIT, the patients showed significantly increased ALFF in the right S1 after the treatment. These findings demonstrated brain functional reorganization in sensoriomotor, cognitive-emotional and auditory/language related regions, and MIT may promote the rehabilitation by reversing the functionally reorganized sensoriomotor areas, which may provide a possible mechanism for MIT.

RATIONALE AND OBJECTIVES:We aimed to investigate the different brain activation patterns and alterations in somatosensory pathways in complete spinal cord injury (CSCI) and incomplete spinal cord injury (ISCI) patients and to provide a theoretical basis for the rehabilitation of somatosensory function in SCI patients. MATERIALS AND METHODS:Fifteen CSCI patients, 15 ISCI patients and 24 healthy controls (HCs) underwent somatosensory stimulation tasks during brain functional magnetic resonance imaging. The brain activation patterns were compared. On the basis of evidence from the underlying somatosensory pathways, several somatosensory-related brain regions were selected as regions of interest (ROIs). Granger causality analysis (GCA)-an effective connectivity (EC) analysis technique-was used to measure the directional functional information flow among the aforementioned ROIs to detect alterations in the somatosensory pathways. RESULTS:Regarding brain activation patterns, compared with the ISCI and HCs groups, the CSCI group presented significant decreases in brain activation intensity in the bilateral insula (INS) and Rolandic operculum (ROL) (cluster-level FDR correction with p < 0.05). GCA-based EC calculations revealed that compared with the ISCI group, the CSCI group presented lower EC from the right thalamus and INS to the right postcentral gyrus (PoCG) (p < 0.001; p = 0.003; separately). Compared with HCs group, decreased ECs from the right ROL to the right PoCG were found in both the CSCI and ISCI groups (p = 0.001; p = 0.006; separately). CONCLUSION:In conclusion, CSCI and ISCI patients exhibited different brain activations and alterations in somatosensory pathways, laying the theoretical foundation for somatosensory rehabilitation in SCI patients.

OBJECTIVE:Investigating structural changes in the cervical spinal cord and brain in children with complete thoracolumbar spinal cord injury (TLSCI) and their correlation with clinical function may provide objective imaging indicators for functional evaluation. METHODS:Twenty-one children with complete TLSCI and twenty-one typically developing (TD) children were enrolled in this study. All participants underwent whole-brain and upper cervical spinal cord sagittal 3D T1-weighted and whole-brain axial diffusion tensor imaging scans using a 3.0T MRI scanner. Utilizing the Spinal Cord Toolbox, cervical spinal cord morphological parameters were obtained. Brain structure changes were analyzed with voxel-based morphometry (VBM) and voxel-based analysis (VBA). RESULTS:Compared to TD children, children with TLSCI showed significant reductions in the CSA (P = .011) and APW (P = .002) at the C2/3 level, as well as significant atrophy in the gray matter volume (GMV) of the left thalamus (P = .026), and bilateral paracentral lobule (PCL, P = .002). There was a significant positive correlation (r = 0.540, P = .017) between GMV of bilateral PCL and sensory scores. The VBA results showed a significant increase in fractional anisotropy values in the right posterior limb of the internal capsule, posterior thalamic radiation, and superior longitudinal fasciculus (SLF, P = .045), the mean diffusivity value of the right SLF was significantly decreased (P = .049) in children with TLSCI. CONCLUSIONS:In children with complete TLSCI, specific structural changes in the cervical spinal cord and brain were observed. A significant correlation between GMV of bilateral PCL and sensory scores may provide imaging biomarkers for assessing neurologic function and therapeutic efficacy (Ethics No: [2020] 003).

Traumatic complete spinal cord injury (CSCI) leads to severe impairment of sensory-motor function, and patients often suffer from neuropsychological deficits such as anxiety, depression, and cognitive deficits, which involve different brain functional modules. However, the alterations in modular organization and the interactions between these modules in pediatric patients with CSCI remain unclear. In this study, a total of 70 participants, including 34 pediatric CSCI patients and 36 healthy controls (HCs) aged 6 to 12 years, underwent whole-brain resting-state functional MRI. The functional networks were analyzed via a graph theory approach based on the 90-region Automated Anatomical Labeling (AAL 90) atlas, generating a 90 × 90 correlation matrix. Metrics for nodal, global, and modular scales were calculated to evaluate alterations in the network's topology. Between-group comparisons and partial correlation analysis were performed. Compared to HCs, pediatric CSCI patients exhibited significant decreases in nodal metrics, particularly in subcortical networks (SN) like the bilateral thalamus. Besides, the distribution of core nodes changed, with five newly added core nodes primarily located in the regions of the default mode network (DMN). For modular interactions, patients group presented increased connectivity within the DMN and between the DMN and the attention network (AN) but reduced connectivity between DMN and SN, DMN and vision network (VN), and AN and SN. Notably, the participation coefficient (Pc) of the TPOmid.L (left temporal pole: middle temporal gyrus) was positively correlated with motor scores, suggesting its potential as an indicator for evaluating the motor function in pediatric CSCI patients. Additionally, the patients demonstrated a different modular structure with significantly lower modularity. These findings suggest that functional network and modular alterations chiefly occur in emotional cognition and vision-associated regions, emphasizing the importance to focus on their psychocognitive well-being and providing evidence for visual-feedback related rehabilitation strategies.

AIMS:To investigate the alterations in effective brain connectivity in pediatric patients with spinal cord injury (SCI), to reveal the mechanism of brain network reorganization and to identify potential key targets for therapeutic neuromodulation interventions. METHODS:This study enrolled 37 pediatric patients with SCI (24 with complete SCI, 13 with incomplete SCI) and 37 matched healthy controls. All participants underwent resting-state functional MRI. Independent component analysis was conducted to identify intrinsic brain networks and obtain key regions of interest. Dynamic causal modeling (DCM) was applied to further analyze the effective connectivity (EC). RESULTS:Patients with SCI showed significantly reduced connectivity between the default mode network (DMN) and the salience network (SAN). DCM revealed that the posterior cingulate cortex (PCC) was a key upstream regulator, exerting enhanced inhibitory influence on the medial prefrontal cortex, bilateral insula, and bilateral inferior parietal lobule. Subgroup analyses revealed that complete SCI was associated with increased excitatory drive from the DMN to the SAN, but enhanced inhibitory influence in the reverse pathway compared to incomplete SCI. CONCLUSION:The PCC is a pivotal node in post-SCI brain reorganization, suggesting it as a potential neuromodulation target. The bidirectional DMN-SAN regulatory imbalance is closely related to SCI severity.

Objective To comparative analysis of clinical characteristics, pathological types, and prognosis of focal cortical dysplasia (FCD) with positive and negative MRI. Methods and Results A total of 96 patients with FCD who underwent epileptic foci resection surgery at Xuanwu Hospital, Capital Medical University from January 2015 to June 2021 were selected. According to the presence of abnormal imaging findings in preoperative FLAIR imaging, patients were divided into MRI positive group (n = 39) and MRI negative group (n = 57). The proportion of FCDⅡA in the MRI negative group was higher than that in the MRI positive group (χ2 = 8.370, P = 0.004); there was a statistically significant difference in the types of epileptic seizures between the 2 groups (Fisher's exact probability: P = 0.037). Among them, the MRI negative group had a higher proportion of complete loss of consciousness seizures (Fisher's exact probability: P = 0.036) and multiple types of seizures (Fisher's exact probability: P = 0.036) than the MRI positive group, with a higher proportion of patients with focal perceptual seizures. The MRI negative group had a higher proportion of complete loss of consciousness seizures (adjusted χ2 = 4.728, P = 0.030) and multiple types of seizures (adjusted χ2 = 4.728, P = 0.030) than the MRI positive group, with a higher proportion of patients with focal perceptual deficit seizures. The proportion of postoperative epileptic seizures in the MRI negative group was higher than that in the MRI positive group (χ2 = 9.013, P = 0.003). Conclusions The proportion of epileptic seizures in MRI negative FCD patients 2 years after surgery is higher than that in MRI positive FCD patients. The proportion of FCDⅡA in MRI negative FCD patients is higher than that in MRI positive FCD patients. MRI negative FCD patients mainly have complete loss of consciousness seizures and multiple types of seizures.

Human brain charts provide unprecedented opportunities for decoding neurodevelopmental milestones and establishing clinical benchmarks for precision brain medicine 1-7. However, current lifespan brain charts are primarily derived from European and North American cohorts, with Asian populations severely underrepresented. Here, we present the first population-specific brain charts for China, developed through the Chinese Lifespan Brain Mapping Consortium (Phase I) using neuroimaging data from 43,037 participants (aged 0-100 years) across 384 sites nationwide. We establish the lifespan normative trajectories for 296 structural brain phenotypes, encompassing global, subcortical, and cortical measures. Cross-population comparisons with Western brain charts (based on data from 56,339 participants aged 0-100 years) reveal distinct neurodevelopmental patterns in the Chinese population, including prolonged cortical and subcortical maturation, accelerated cerebellar growth, and earlier development of sensorimotor regions relative to paralimbic regions. Crucially, these Chinese-specific charts outperform Western-derived models in predicting healthy brain phenotypes and detecting pathological deviations in Chinese clinical cohorts. These findings highlight the urgent need for diverse, population-representative brain charts to advance equitable precision neuroscience and improve clinical validity across populations.

Cross-sectional study. This study investigates changes in spinal DTI metrics above lesion in children with spinal cord injury without fracture or dislocation (SCIWOFD), aiming to assess DTI’s potential as a diagnostic and evaluative tool for SCIWOFD in children. Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China. This study included 18 children with SCIWOFD and 12 typically developing (TD) children. SCIWOFD children underwent International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments and MRI with axial spinal cord DTI. DTI data were processed with Diffusion Toolkit and TrackVis, with four levels above the lesion (Level 1 to Level 4). Spinal DTI metrics were extracted, and statistical analysis was performed using multiple linear regression and Pearson correlation. Compared to the TD group, the SCIWOFD group displayed significant changes in DTI metrics at four spinal cord levels. At level 1, FA decreased (p < 0.000), while MD (p < 0.000), AD (p = 0.007), and RD (p < 0.000) increased. Levels 2 and 3 showed decreased FA (level 2: p < 0.000; level 3: p = 0.001) and increased MD (level 2: p = 0.001; level 3: p = 0.029) and RD values (level 2: p < 0.000; level 3:p = 0.001). At level 4, FA decreased (p < 0.000), while RD increased (p = 0.009). At level 1 in the SCIWOFD group, MD (r = −0.534, p = 0.022) and RD (r = −0.569, p = 0.009) correlated with sensory scores. Spinal DTI metrics above the lesion in children with SCIWOFD exhibit gradient changes, with a statistically correlation between the DTI metrics at the rostral edge of the lesion and ISNCSCI sensory scores. DTI metrics may serve as stable, objective indicators for assessing SCIWOFD in children.

Brain gray matter (GM) and white matter alterations have been studied in pediatric spinal cord injury (SCI) patients. However, the differences in brain reorganization between complete SCI (CSCI) and incomplete SCI (ICSCI) remain unclear. The objective of the study was to explore the different effects of CSCI and ICSCI on brain structure in pediatric patients. A total of 68 children with SCI (37 with CSCI and 31 with ICSCI) and 36 age-matched healthy controls (HCs) were enrolled. The clinical data on motor and sensory scores, degree of injury, duration of injury, and age at the time of injury were assessed. GM volume (GMV) and diffusion tensor imaging (DTI) indices were analyzed using voxel-based morphometry and tract-based spatial statistics. Both CSCI and ICSCI patients exhibited abnormalities in GMV and DTI metrics within brain regions associated with sensorimotor functions, emotional processing, and pain perception. Notably, the ICSCI group showed significantly reduced GMV in the left thalamus (p < 0.001, t = − 5.275), right caudate nucleus (p < 0.001, t = − 4.992), and left precuneus (p = 0.002, t = − 4.053) compared to the CSCI group. Our study showed that pediatric patients with CSCI and ICSCI exhibit distinct patterns of GM reorganization in regions involved in sensory processing and cognitive functions.

AIMS:To study the changes in cortical thickness and subcortical gray matter structures in children with complete spinal cord injury (CSCI), reveal the possible causes of dysfunction beyond sensory motor dysfunction after CSCI, and provide a possible neural basis for corresponding functional intervention training. METHODS:Thirty-seven pediatric CSCI patients and 34 age-, gender-matched healthy children as healthy controls (HCs) were recruited. The 3D high-resolution T1-weighted structural images of all subjects were obtained using a 3.0 Tesla MRI system. Statistical differences between pediatric CSCI patients and HCs in cortical thickness and volumes of subcortical gray matter structures were evaluated. Then, correlation analyses were performed to analyze the correlation between the imaging indicators and clinical characteristics. RESULTS:Compared with HCs, pediatric CSCI patients showed decreased cortical thickness in the right precentral gyrus, superior temporal gyrus, and posterior segment of the lateral sulcus, while increased cortical thickness in the right lingual gyrus and inferior occipital gyrus. The volume of the right thalamus in pediatric CSCI patients was significantly smaller than that in HCs. No significant correlation was found between the imaging indicators and the injury duration, sensory scores, and motor scores of pediatric CSCI patients. CONCLUSIONS:These findings demonstrated that the brain structural reorganizations of pediatric CSCI occurred not only in sensory motor areas but also in cognitive and visual related brain regions, which may suggest that the visual processing, cognitive abnormalities, and related early intervention therapy also deserve greater attention beyond sensory motor rehabilitation training in pediatric CSCI patients.

BackgroundAt present, the diagnosis of post-traumatic stress disorder（PTSD） mainly relies on clinical symptoms and psychological scales, and finding objective indicators that are helpful for diagnosis has always been a challenge in clinical practice and academic research. Neuroimaging is a useful and powerful tool for discovering the biomarkers of PTSD,especially functional MRI (fMRI), structural MRI (sMRI) and Diffusion Weighted Imaging（DTI）are the most commonly used technologies, which can provide multiple perspectives on brain function, structure and its connectivity. Machine learning (ML) is an emerging and potentially powerful method, which has aroused people's interest because it is used together with neuroimaging data to define brain structural and functional abnormalities related to diseases, and identify phenotypes, such as helping physicians make early diagnosis.ObjectivesAccording to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) declaration, a systematic review was conducted to assess its accuracy in distinguishing between PTSD patients, TEHC(Trauma-Exposed Healthy Controls), and HC(healthy controls).MethodsWe searched PubMed, Embase, and Web of Science using common words for ML methods and PTSD until June 2023, with no language or time limits. This review includes 13 studies, with sensitivity, specificity, and accuracy taken from each publication or acquired directly from the authors.ResultsAll ML techniques have an diagnostic accuracy rate above 70%，and support vector machine（SVM） are the most commonly used techniques. This series of studies has revealed significant neurobiological differences in key brain regions among individuals with PTSD, TEHC, and HC. The connectivity patterns of regions such as the Insula and Amygdala hold particular significance in distinguishing these groups. TEHC exhibits more normal connectivity patterns compared to PTSD, providing valuable insights for the application of machine learning in PTSD diagnosis.ConclusionIn contrast to any currently available assessment and clinical diagnosis, ML techniques can be used as an effective and non-invasive support for early identification and detection of patients as well as for early screening of high-risk populations.

AIMS:To compare the changes in brain network topological properties and structure-function coupling in patients with complete spinal cord injury (CSCI) and incomplete spinal cord injury (ICSCI), to unveil the potential neurobiological mechanisms underlying the different effects of CSCI and ICSCI on brain networks and identify objective neurobiological markers to differentiate between CSCI and ICSCI patients. METHODS:Thirty-five SCI patients (20 CSCI and 15 ICSCI) and 32 healthy controls (HCs) were included in the study. Here, networks were constructed using resting-state functional magnetic resonance imaging to analyze functional connectivity (FC) and diffusion tensor imaging for structural connectivity (SC). Then, graph theory analysis was used to examine SC and FC networks, as well as to estimate SC-FC coupling values. RESULTS:Compared with HCs, CSCI patients showed increased path length (Lp), decreased global efficiency (Eg), and local efficiency (Eloc) in SC. For FC, ICSCI patients exhibited increased small-worldness, clustering coefficient (Cp), normalized clustering coefficient, and Eloc. Also, ICSCI patients showed increased Cp and Eloc than CSCI patients. Additionally, ICSCI patients had reduced SC-FC coupling values compared to HCs. Moreover, in CSCI patients, the SC network's Lp and Eg values were significantly correlated with motor scores, while in ICSCI patients, the FC network's Cp, Eloc, and SC-FC coupling values were related to sensory/motor scores. CONCLUSIONS:These results suggest that CSCI patients are characterized by decreased efficiency in the SC network, while ICSCI patients are distinguished by increased local connections and SC-FC decoupling. Moreover, the differences in network metrics between CSCI and ICSCI patients could serve as objective biological markers, providing a basis for diagnosis and treatment strategies.

Neuropathic pain (NP) is a common and persistent disease that leads to immense suffering and serious social burden. Incomplete understanding of the underlying neural basis makes it difficult to achieve significant breakthroughs in the treatment of NP. We aimed to review the functional and structural brain topological properties in patients with NP and consider how graph measures reveal potential mechanisms and are applied to clinical practice. Related studies were searched in PubMed and Web of Science databases. Topological property changes in patients with NP, including small-worldness, functional separation, integration, and centrality metrics, were reviewed. The findings suggest that NP was characterized by retained but declined small-worldness, indicating an insidious imbalance between network integration and segregation. The global-level measures revealed decreased global and local efficiency in the NP, implying decreased information transfer efficiency for both long- and short-range connections. Altered nodal centrality measures involve various brain regions, mostly those associated with pain, cognition, and emotion. Graph theory is a powerful tool for identifying topological properties of patients with NP. These specific brain changes in patients with NP are very helpful in revealing the potential mechanisms of NP, developing new treatment strategies, and evaluating the efficacy and prognosis of NP.

BACKGROUND AND PURPOSE:Currently, there is no effective treatment for pediatric patients with complete spinal cord injury. Motor imagery has been proposed as an alternative to physical training for patients who are unable to move voluntarily. Our aim was to reveal the potential mechanism of motor imagery in the rehabilitation of pediatric complete spinal cord injury.MATERIALS AND METHODS:Twenty-six pediatric patients with complete spinal cord injury and 26 age- and sex-matched healthy children as healthy controls were recruited. All participants underwent the motor imagery task-related fMRI scans, and additional motor execution scans were performed only on healthy controls. First, we compared the brain-activation patterns between motor imagery and motor execution in healthy controls. Then, we compared the brain activation of motor imagery between the 2 groups and compared the brain activation of motor imagery in pediatric patients with complete spinal cord injury and that of motor execution in healthy controls.RESULTS:In healthy controls, compared with motor execution, motor imagery showed increased activation in the left inferior parietal lobule and decreased activation in the left supplementary motor area, paracentral lobule, middle cingulate cortex, and right insula. In addition, our results revealed that the 2 groups both activated the bilateral supplementary motor area, middle cingulate cortex and left inferior parietal lobule, and supramarginal gyrus during motor imagery. Compared with healthy controls, higher activation in the bilateral paracentral lobule, supplementary motor area, putamen, and cerebellar lobules III-V was detected in pediatric complete spinal cord injury during motor imagery, and the activation of these regions was even higher than that of healthy controls during motor execution.CONCLUSIONS:Our study demonstrated that part of the motor imagery network was functionally preserved in pediatric complete spinal cord injury and could be activated through motor imagery. In addition, higher-level activation in sensorimotor-related regions was also found in pediatric complete spinal cord injury during motor imagery. Our findings may provide a theoretic basis for the application of motor imagery training in pediatric complete spinal cord injury.

Visual feedback training (VFT) plays an important role in the motor rehabilitation of patients with spinal cord injury (SCI). However, the neural mechanisms are unclear. We aimed to investigate the changes in dynamic functional network connectivity (FNC) related to visual networks (VN) in patients with SCI and to reveal the neural mechanism of VFT promoting motor function rehabilitation. Dynamic FNC and the sliding window method were performed in 18 complete SCI (CSCI), 16 patients with incomplete SCI (ISCI), and 42 healthy controls (HCs). Then, k-mean clustering was implemented to identify discrete FNC states, and temporal properties were computed. The correlations between these dynamic features and neurological parameters in all patients with SCI were calculated. The majority of aberrant FNC was manifested between VN and executive control network (ECN). In addition, compared with HCs, temporal metrics derived from state transition vectors were decreased in patients with CSCI including the mean dwell time and the fraction of time spent in state 3. Furthermore, the disrupted FNC between salience network and ECN in state 2 and the number of transitions were all positively correlated with neurological scores in patients with SCI. Our findings indicated that SCI could result in VN-related FNC alterations, revealing the possible mechanism for VFT in rehabilitation of patients with SCI and increasing the training efficacy and promoting rehabilitation for SCI.