Differential brain reorganization in chronic cervical spinal cord injury and its relation to motor versus sensory impairments: a preliminary investigation

Brihmat N(1)(2)(3), Saleh S(4)(5), Zhang F(6)(7), Carnahan J(6), Bayram
MB(6)(7), Yue GH(7)(8), Forrest GF(9)(10)(11).

Author information:
(1)Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation,
1199 Pleasant Valley Way, West Orange, NJ, 07052, USA.
.
(2)Department of Physical Medicine and Rehabilitation, Rutgers New Jersey
Medical School, 183 South Orange Avenue, Newark, NJ, 07101, USA.
.
(3)Univ. Bordeaux, CNRS, IMN, UMR 5293, 146 Rue Léo Saignat, F-33000, Bordeaux,
France. .
(4)Department of Rehabilitation and Movement Sciences, Rutgers School of Health
Professions, 65 Bergen Street, Suite 120, Newark, NJ, 07107-1709, USA.
(5)Department of Neurology, Robert Wood Johnson Medical School (RWJMS), 125
Paterson Street, Suite 6200, New Brunswick, NJ, USA.
(6)Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation,
1199 Pleasant Valley Way, West Orange, NJ, 07052, USA.
(7)Department of Physical Medicine and Rehabilitation, Rutgers New Jersey
Medical School, 183 South Orange Avenue, Newark, NJ, 07101, USA.
(8)Center for Mobility and Rehabilitation Engineering Research, Kessler
Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA.
(9)Tim and Caroline Reynolds Center for Spinal Stimulation, Kessler Foundation,
1199 Pleasant Valley Way, West Orange, NJ, 07052, USA.
.
(10)Department of Physical Medicine and Rehabilitation, Rutgers New Jersey
Medical School, 183 South Orange Avenue, Newark, NJ, 07101, USA.
.
(11)Center for Mobility and Rehabilitation Engineering Research, Kessler
Foundation, 1199 Pleasant Valley Way, West Orange, NJ, 07052, USA.
.

Spinal cord injury (SCI) disrupts the communication between the brain and the
rest of the body, triggering widespread spinal and supraspinal changes resulting
in a cascade of functional impairments. MRI has proved useful to investigate
neural circuits reorganization, offering insights into the neuroplastic changes
underlying specific impairments and deficits. However, it remains unclear
whether different impairments are associated with differential patterns of
structural and functional brain reorganization, a knowledge gap addressed in
this study. Anatomical and resting-state functional MRI data from 12
participants with complete and incomplete chronic cervical SCI and 12 age- and
sex-matched able-bodied individuals were acquired. SCI participants’ arm and
hand sensory and motor functions were assessed using the Graded Redefined
Assessment of Strength Sensibility and Prehension scale. Cortical thickness,
gray matter volume and resting-state functional connectivity (rs-FC) were
measured and compared between groups while also considering changes in clinical
scores in SCI. Widespread structural and functional changes in various cortical
and subcortical regions were highlighted in individuals with chronic cervical
SCI as compared to the able-bodied controls. Specific alterations were seen in
cortical thickness, gray matter volume and rs-FC of the sensorimotor, and
visuospatial processing networks. Mainly rs-FC of sensorimotor cortical and
subcortical areas showed changes differentially associated to only-motor versus
sensory deficits in the SCI group. Motor and sensory impairments at the chronic
stage appears associated with differential patterns of brain reorganization in
individuals with chronic cervical SCI, prominently involving regions of the
visual and visuospatial networks. Some of the regions with altered rs-FC,
notably the thalamus and putamen, showed also changes in their anatomy in SCI.
The findings confirm the value of multimodal brain MRI for characterizing neural
correlates of specific impairments following SCI and informing personalized
therapeutic strategies. Our results support the consideration of interventions
that engage visual and visuospatial networks to promote function recovery after
SCI.

© 2026. The Author(s).

DOI: 10.1038/s41598-026-36187-w
PMCID: PMC12921277
PMID: 41634088 [Indexed for MEDLINE]

Conflict of interest statement: Declarations. Competing interests: The authors
declare no competing interests.

Auteurs Bordeaux Neurocampus