Cortical Activation During Visual Illusory Walking in Persons With Spinal Cord Injury: A Pilot Study

• We examined cortical activation during an illusory walking paradigm in persons with spinal cord injury.
• Persons with spinal cord injury showed activation in the somatosensory cortex.
• Able-bodied persons showed activation in the premotor cortical areas.

ObjectiveTo determine the location of cortical activation during a visual illusion walking paradigm, a recently proposed treatment for spinal cord injury (SCI)–related neuropathic pain, in persons with SCI compared with able-bodied controls.DesignPilot experimental functional magnetic resonance imaging (fMRI) trial.SettingOutpatient rehabilitation clinic.ParticipantsPersons with paraplegia (n=3) and able-bodied participants (n=5) were included in this study.InterventionsNot applicable.Main Outcome MeasureCortical activation as measured by the blood oxygenation level-dependent method of fMRI.ResultsDuring 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.ConclusionsTreatment modalities for SCI-related neuropathic pain that are based on sensory input paradigms (eg, virtual walking, visual illusory walking) may work by targeting the somatosensory cortex, an area that has been previously found to functionally reorganize after SCI.