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Cooper Medical Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001061","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Human Brain Mapping"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Trauma to the spinal cord rarely results in complete division of the cord with surviving nerves sometimes remaining <jats:italic>silent<\/jats:italic> or failing to function normally. The term <jats:italic>motor<\/jats:italic> or <jats:italic>sensory discomplete<\/jats:italic> has been used to describe this important but unclassified subgroup of complete SCI. Importantly, <jats:italic>silent<\/jats:italic> motor or sensory pathways may contribute to aversive symptoms (spasticity, pain) or improved treatment success. To demonstrate more objectively the presence of subclinical preserved somatosensory pathways in clinically complete SCI, a cross\u2010sectional study using functional MRI (fMRI) was undertaken. The presence of brain activation following innocuous brushing of an insensate region below\u2010injury (great toe) was analyzed in 23 people (19 males (83%), mean\u2009\u00b1\u2009SD age 43\u2009\u00b1\u200913 years) with clinically complete (AIS A) SCI with (<jats:italic>n<\/jats:italic>\u2009=\u200913) and without (<jats:italic>n<\/jats:italic>\u2009=\u200910) below\u2010level neuropathic pain and 21 people without SCI or pain (15 males (71%); mean\u2009\u00b1\u2009SD age 41\u2009\u00b1\u200914 years). Location appropriate, significant fMRI brain activation was detected in 48% (<jats:italic>n<\/jats:italic>\u2009=\u200911\/23) of subjects with clinically complete SCI from below\u2010injury stimulation. No association was found between the presence of subclinical sensory pathways transmitting innocuous mechanical stimuli (dorsal column medical lemniscal) and below\u2010level neuropathic pain (<jats:italic>\u03c7<\/jats:italic><jats:sup>2<\/jats:sup>\u00a0=\u00a00.034, <jats:italic>P<\/jats:italic>\u2009=\u20090.9). The high prevalence of sensory discomplete injuries (\u223c50% complete SCI) strengthens the case to explore inclusion of this category into the international SCI taxonomy (ISNCSCI). This would ensure more widespread inclusion of discomplete SCI in ongoing pain and motor recovery research. Neurophysiological tests such as fMRI may play a role in this process. <jats:italic>Hum Brain Mapp 39:588\u2013598, 2018<\/jats:italic>. \u00a9 <jats:bold>2017 Wiley Periodicals, Inc.<\/jats:bold><\/jats:p>","DOI":"10.1002\/hbm.23868","type":"journal-article","created":{"date-parts":[[2017,10,28]],"date-time":"2017-10-28T05:22:57Z","timestamp":1509168177000},"page":"588-598","source":"Crossref","is-referenced-by-count":64,"title":["New evidence for preserved somatosensory pathways in complete spinal cord injury: A fMRI study"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0960-4102","authenticated-orcid":false,"given":"Paul J.","family":"Wrigley","sequence":"first","affiliation":[{"name":"Pain Management Research Institute, Kolling Institute of Medical Research, Northern Sydney Local Health District St Leonards New South Wales 2065 Australia"},{"name":"Sydney Medical School Northern, University of Sydney  New South Wales 2006 Australia"},{"name":"Michael J Cousins Pain Management and Research Centre, Royal North Shore Hospital, Northern Sydney Local Health District St Leonards New South Wales 2065 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip J.","family":"Siddall","sequence":"additional","affiliation":[{"name":"Sydney Medical School Northern, University of Sydney  New South Wales 2006 Australia"},{"name":"Department of Pain Management HammondCare, Greenwich Hospital Greenwich New South Wales 2065 Australia"},{"name":"Kolling Institute of Medical Research, Northern Sydney Local Health District St Leonards New South Wales 2065 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia M.","family":"Gustin","sequence":"additional","affiliation":[{"name":"School of Psychology, University of New South Wales  New South Wales 2052 Australia"},{"name":"Neuroscience Research Australia  New South Wales 2031 Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,10,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.2340\/16501977-1955","article-title":"Preserved somatosensory conduction in a patient with complete cervical spinal cord injury","volume":"47","author":"Awad A","year":"2015","journal-title":"J Rehabil Med"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sc.2011.156"},{"key":"e_1_2_8_4_1","first-page":"75","article-title":"Observations on the pathology of human spinal cord injury. 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