{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T01:51:27Z","timestamp":1781229087768,"version":"3.54.1"},"reference-count":112,"publisher":"American Spinal Injury Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>About 69% of the 299,000 Americans living with spinal cord injury (SCI) experience long-term debilitating neuropathic pain. New treatments are needed because current treatments do not provide enough pain relief. We have found that insular-opercular brain network alterations may contribute to neuropathic pain and that restoring this network could reduce neuropathic pain. Here, we outline a study protocol using a physical therapy approach, cognitive multisensory rehabilitation (CMR), which has been shown to restore OP1\/OP4 connections in adults post stroke, to test our hypothesis that CMR can normalize pain perception through restoring OP1\/OP4 connectivity in adults with SCI and relieve neuropathic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare baseline brain function via resting-state and task-based functional magnetic resonance imaging in adults with SCI versus uninjured controls, and to identify changes in brain function and behavioral pain outcomes after CMR in adults with SCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this phase I randomized controlled trial, adults with SCI will be randomized into two groups: Group A will receive 6 weeks of CMR followed by 6 weeks of standard of care (no therapy) at home. Group B will start with 6 weeks of standard of care (no therapy) at home and then receive 6 weeks of CMR. Neuroimaging and behavioral measures are collected at baseline, after the first 6 weeks (A: post therapy, B: post waitlist), and after the second 6 weeks (A: post-therapy follow-up, B: post therapy), with follow-up of both groups up to 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The successful outcome of our study will be a critical next step toward implementing CMR in clinical care to improve health in adults with SCI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.46292\/sci22-00006","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T12:08:55Z","timestamp":1668600535000},"page":"33-43","source":"Crossref","is-referenced-by-count":11,"title":["Identifying Body Awareness-Related Brain Network Changes After Cognitive Multisensory Rehabilitation for Neuropathic Pain Relief in Adults With Spinal Cord Injury: Protocol of a Phase I Randomized Controlled Trial"],"prefix":"10.46292","volume":"28","author":[{"given":"Ann","family":"Van de Winckel","sequence":"first","affiliation":[{"name":"Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sydney","family":"Carpentier","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Deng","sequence":"additional","affiliation":[{"name":"Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Bottale","sequence":"additional","affiliation":[{"name":"Centro Studi di Riabilitazione Neurocognitiva - Villa Miari (Study Center for Cognitive Multisensory Rehabilitation), Santorso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Hendrickson","sequence":"additional","affiliation":[{"name":"University of Minnesota Informatics Institute, Office of the Vice President for Research, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Wudlick","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clas","family":"Linnman","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Battaglino","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leslie","family":"Morse","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"key":"i1945-5763-28-4-33-b1","series-title":"Spinal Cord Injury Facts and Figures at a Glance: 2022 SCI 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 Wongphaet\n              P,\n            \n            \n              Chavanich\n              N,\n            \n          \n          .\n\t\t\t\t\tA randomized controlled trial of Cognitive Sensory Motor Training Therapy on the recovery of arm function in acute stroke patients.\n\t\t\t\t\tClin Rehabil.\n\t\t\t\t\t2012;\n\t\t\t\t\t26:\n\t\t\t\t\t1096\u2013\n\t\t\t\t\t1104."},{"key":"i1945-5763-28-4-33-b32","series-title":"Eur J Phys Rehabil Med","first-page":"255","article-title":"Neurocognitive therapeutic exercise improves pain and function in patients with shoulder impingement syndrome: A single-blind randomized controlled clinical trial","volume":"50","year":"2014","unstructured":"Marzetti\n              E,\n            \n            \n              Rabini\n              A,\n            \n            \n              Piccinini\n              G,\n            \n          \n          .\n\t\t\t\t\tNeurocognitive therapeutic exercise improves pain and function in patients with shoulder impingement syndrome: A single-blind randomized controlled clinical trial.\n\t\t\t\t\tEur J Phys Rehabil Med.\n\t\t\t\t\t2014;\n\t\t\t\t\t50:\n\t\t\t\t\t255\u2013\n\t\t\t\t\t264."},{"key":"i1945-5763-28-4-33-b33","series-title":"Eur J Phys Rehabil Med","first-page":"81","article-title":"Early versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: Proprioceptive or cognitive approach?","volume":"52","year":"2016","unstructured":"Morreale\n              M,\n            \n            \n              Marchione\n              P,\n            \n            \n              Pili\n              A,\n            \n          \n          .\n\t\t\t\t\tEarly versus delayed rehabilitation treatment in hemiplegic patients with ischemic stroke: Proprioceptive or cognitive approach?Eur J Phys Rehabil Med.\n\t\t\t\t\t2016;\n\t\t\t\t\t52:\n\t\t\t\t\t81\u2013\n\t\t\t\t\t89."},{"key":"i1945-5763-28-4-33-b34","series-title":"J Phys Ther Sci","first-page":"665","article-title":"A neurocognitive approach for recovering upper extremity movement following subacute stroke: A randomized controlled pilot study","volume":"29","year":"2017","unstructured":"Sall\u00e9s\n              L,\n            \n            \n              Mart\u00edn-Casas\n              P,\n            \n            \n              Giron\u00e8s\n              X,\n            \n            \n              Dur\u00e0\n              MJ,\n            \n            \n              Lafuente\n              JV,\n            \n            \n              Perfetti\n              C.\n            \n          \n          A neurocognitive approach for recovering upper extremity movement following subacute stroke: A randomized controlled pilot study.\n\t\t\t\t\tJ Phys Ther Sci.\n\t\t\t\t\t2017;\n\t\t\t\t\t29:\n\t\t\t\t\t665\u2013\n\t\t\t\t\t672."},{"key":"i1945-5763-28-4-33-b35","series-title":"J Neurol Phys Ther","first-page":"164","article-title":"Visual and motor recovery after \u201ccognitive therapeutic 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Accessed May 24, 2020."},{"key":"i1945-5763-28-4-33-b41","series-title":"Neuroimage","first-page":"463","article-title":"The effect of resting condition on resting-state fMRI reliability and consistency: A comparison between resting with eyes open, closed, and fixated","volume":"78","year":"2013","unstructured":"Patriat\n              R,\n            \n            \n              Molloy\n              EK,\n            \n            \n              Meier\n              TB,\n            \n          \n          .\n\t\t\t\t\tThe effect of resting condition on resting-state fMRI reliability and consistency: A comparison between resting with eyes open, closed, and fixated.\n\t\t\t\t\tNeuroimage.\n\t\t\t\t\t2013;\n\t\t\t\t\t78:\n\t\t\t\t\t463\u2013\n\t\t\t\t\t473."},{"key":"i1945-5763-28-4-33-b42","series-title":"Spinal Cord","first-page":"282","article-title":"The International Spinal Cord Injury Pain Basic Data Set (version 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analysis","volume":"98","year":"2018","unstructured":"Dragesund\n              T,\n            \n            \n              Strand\n              LI,\n            \n            \n              Grotle\n              M.\n            \n          \n          The Revised Body Awareness Rating Questionnaire: Development into a unidimensional scale using Rasch analysis.\n\t\t\t\t\tPhys Ther.\n\t\t\t\t\t2018;\n\t\t\t\t\t98:\n\t\t\t\t\t122\u2013\n\t\t\t\t\t132."},{"key":"i1945-5763-28-4-33-b49","series-title":"Arch Phys Med Rehabil","first-page":"1745","article-title":"Spinal Cord Injury\u2013Functional Index\/Assistive Technology Short Forms","volume":"97","year":"2016","unstructured":"Slavin\n              MD,\n            \n            \n              Ni\n              P,\n            \n            \n              Tulsky\n              DS,\n            \n          \n          .\n\t\t\t\t\tSpinal Cord Injury\u2013Functional Index\/Assistive Technology Short Forms.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2016;\n\t\t\t\t\t97:\n\t\t\t\t\t1745\u2013\n\t\t\t\t\t52.e7."},{"key":"i1945-5763-28-4-33-b50","series-title":"J Orthop Sports Phys Ther","first-page":"331","article-title":"The patient-specific functional scale: Validation of its use in persons with neck dysfunction","volume":"27","year":"1998","unstructured":"Westaway\n              MD,\n            \n            \n              Stratford\n              PW,\n            \n            \n              Binkley\n              JM.\n            \n          \n          The patient-specific functional scale: Validation of its use in persons with neck dysfunction.\n\t\t\t\t\tJ Orthop Sports Phys Ther.\n\t\t\t\t\t1998;\n\t\t\t\t\t27:\n\t\t\t\t\t331\u2013\n\t\t\t\t\t338."},{"key":"i1945-5763-28-4-33-b51","series-title":"Brain Connect","first-page":"125","article-title":"Conn: A functional connectivity toolbox for correlated and anticorrelated brain networks","volume":"2","year":"2012","unstructured":"Whitfield-Gabrieli\n     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An fMRI study","volume":"34","year":"2013","unstructured":"Van de Winckel\n              A,\n            \n            \n              Klingels\n              K,\n            \n            \n              Bruyninckx\n              F,\n            \n          \n          .\n\t\t\t\t\tHow does brain activation differ in children with unilateral cerebral palsy compared to typically developing children, during active and passive movements, and tactile stimulation? An fMRI study.\n\t\t\t\t\tRes Dev Disabil.\n\t\t\t\t\t2013;\n\t\t\t\t\t34:\n\t\t\t\t\t183\u2013\n\t\t\t\t\t197."},{"key":"i1945-5763-28-4-33-b54","series-title":"Philos Ethics Humanit Med","first-page":"6","article-title":"Body awareness: A phenomenological inquiry into the common ground of mind-body therapies","volume":"6","year":"2011","unstructured":"Mehling\n              WE,\n            \n            \n              Wrubel\n              J,\n            \n            \n              Daubenmier\n              JJ,\n            \n          \n          .\n\t\t\t\t\tBody awareness: A phenomenological inquiry into the common ground of mind-body therapies.\n\t\t\t\t\tPhilos Ethics Humanit Med.\n\t\t\t\t\t2011;\n\t\t\t\t\t6:\n\t\t\t\t\t6."},{"key":"i1945-5763-28-4-33-b55","series-title":"J Clin Med Res","first-page":"2144","article-title":"Disconnected body representation: Neuroplasticity following spinal cord injury","volume":"8","year":"2019","unstructured":"Leemhuis\n              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Res","article-title":"Neuropathic pain following traumatic spinal cord injury: Models, measurement, and mechanisms","year":"2017","unstructured":"Kramer\n              JLK,\n            \n            \n              Minhas\n              NK,\n            \n            \n              Jutzeler\n              CR,\n            \n            \n              Erin\n              LK,\n            \n            \n              Liu\n              LJW,\n            \n            \n              Ramer\n              MS.\n            \n          \n          Neuropathic pain following traumatic spinal cord injury: Models, measurement, and mechanisms.\n\t\t\t\t\tJ Neurosci Res.\n\t\t\t\t\t2017;\n\t\t\t\t\t1295-13-6. https:\/\/doi.org\/10.1002\/jnr.23881"},{"key":"i1945-5763-28-4-33-b5","series-title":"Spinal Cord.","first-page":"352","article-title":"Management of neuropathic pain following spinal cord injury: Now and in the future","year":"2009","unstructured":"Siddall\n              PJ.\n          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study","volume":"134","year":"2022","unstructured":"Goel\n              V,\n            \n            \n              Kumar\n              V,\n            \n            \n              Patwardhan\n              AM,\n            \n          \n          .\n\t\t\t\t\tProcedure-related outcomes including readmission following spinal cord stimulator implant procedures: A retrospective cohort study.\n\t\t\t\t\tAnesth Analg.\n\t\t\t\t\t2022;\n\t\t\t\t\t134(\n\t\t\t\t\t4):\n\t\t\t\t\t843\u2013\n\t\t\t\t\t852. https:\/\/doi.org\/10.1213\/ANE.0000000000005816."},{"issue":"11","key":"i1945-5763-28-4-33-b9","series-title":"Neuroradiology","first-page":"1309","article-title":"Reorganization of the brain in spinal cord injury: A meta-analysis of functional MRI studies","volume":"61","year":"2019","unstructured":"Wang\n              W,\n            \n            \n              Xie\n              W,\n            \n            \n              Zhang\n              Q,\n            \n          \n         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findings","volume":"9","year":"2015","unstructured":"Jutzeler\n              CR,\n            \n            \n              Curt\n              A,\n            \n            \n              Kramer\n              JLK.\n            \n          \n          Relationship between chronic pain and brain reorganization after deafferentation: A systematic review of functional MRI findings.\n\t\t\t\t\tNeuroimage Clin.\n\t\t\t\t\t2015;\n\t\t\t\t\t9:\n\t\t\t\t\t599\u2013\n\t\t\t\t\t606."},{"key":"i1945-5763-28-4-33-b13","series-title":"Front Neurol","first-page":"613630","article-title":"Functional hyperconnectivity and task-based activity changes associated with neuropathic pain after spinal cord injury: A pilot study","volume":"12","year":"2021","unstructured":"Black\n              SR,\n            \n            \n              King\n              JB,\n            \n            \n              Mahan\n              MA,\n            \n            \n              Anderson\n              J,\n        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injury: The impact of sensorimotor activity","volume":"158","year":"2017","unstructured":"Nees\n              TA,\n            \n            \n              Finnerup\n              NB,\n            \n            \n              Blesch\n              A,\n            \n            \n              Weidner\n              N.\n            \n          \n          Neuropathic pain after spinal cord injury: The impact of sensorimotor activity.\n\t\t\t\t\tPain.\n\t\t\t\t\t2017;\n\t\t\t\t\t158:\n\t\t\t\t\t371\u2013\n\t\t\t\t\t376."},{"key":"i1945-5763-28-4-33-b17","series-title":"J Neurotrauma","first-page":"1278","article-title":"Evaluation of whole-brain resting-state functional connectivity in spinal cord injury: A large-scale network analysis using network-based statistic","volume":"34","year":"2017","unstructured":"Kaushal\n              M,\n            \n            \n              Oni-Orisan\n              A,\n            \n            \n              Chen\n              G,\n            \n 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injury","volume":"141","year":"2009","unstructured":"Wrigley\n              PJ,\n            \n            \n              Press\n              SR,\n            \n            \n              Gustin\n              SM,\n            \n          \n          .\n\t\t\t\t\tNeuropathic pain and primary somatosensory cortex reorganization following spinal cord injury.\n\t\t\t\t\tPain.\n\t\t\t\t\t2009;\n\t\t\t\t\t141:\n\t\t\t\t\t52\u2013\n\t\t\t\t\t59."},{"key":"i1945-5763-28-4-33-b23","series-title":"J Pain","first-page":"645","article-title":"Dynamic oscillatory signatures of central neuropathic pain in spinal cord injury","volume":"15","year":"2014","unstructured":"Vuckovic\n              A,\n            \n            \n              Hasan\n              MA,\n            \n            \n              Fraser\n              M,\n            \n            \n              Conway\n              BA,\n            \n            \n              Nasseroleslami\n              B,\n            \n           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Disabil.","first-page":"1710","article-title":"Does somatosensory discrimination activate different brain areas in children with unilateral cerebral palsy compared to typically developing children? 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exercises\u201d in cortical blindness: A case study","volume":"41","year":"2017","unstructured":"De Patre\n              D,\n            \n            \n              Van de Winckel\n              A,\n            \n            \n              Pant\u00e9\n              F,\n            \n          \n          .\n\t\t\t\t\tVisual and motor recovery after \u201ccognitive therapeutic exercises\u201d in cortical blindness: A case study.\n\t\t\t\t\tJ Neurol Phys Ther.\n\t\t\t\t\t2017;\n\t\t\t\t\t41:\n\t\t\t\t\t164\u2013\n\t\t\t\t\t172."},{"key":"i1945-5763-28-4-33-b36","series-title":"Clin J Pain","first-page":"25","article-title":"Clinically significant change in pain intensity ratings in persons with spinal cord injury or amputation","volume":"22","year":"2006","unstructured":"Hanley\n              MA,\n            \n            \n              Jensen\n              MP,\n            \n            \n              Ehde\n              DM,\n            \n          \n          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Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: A reliability and construct validity study","volume":"31","year":"2007","unstructured":"Malouin\n              F,\n            \n            \n              Richards\n              CL,\n            \n            \n              Jackson\n              PL,\n            \n            \n              Lafleur\n              MF,\n            \n            \n              Durand\n              A,\n            \n            \n              Doyon\n              J.\n            \n          \n          The Kinesthetic and Visual Imagery Questionnaire (KVIQ) for assessing motor imagery in persons with physical disabilities: A reliability and construct validity study.\n\t\t\t\t\tJ Neurol Phys Ther.\n\t\t\t\t\t2007;\n\t\t\t\t\t31:\n\t\t\t\t\t20\u2013\n\t\t\t\t\t29."},{"key":"i1945-5763-28-4-33-b39","series-title":"Phys Med Rehabil Clin N Am","first-page":"319","article-title":"Updates of the International Standards for Neurologic Classification of Spinal Cord Injury: 2015 and 2019","volume":"31","year":"2020","unstructured":"Kirshblum\n              S,\n            \n            \n              Snider\n              B,\n            \n            \n              Rupp\n              R,\n            \n            \n              Read\n              MS,\n            \n            International Standards Committee of ASIA and ISCoS.\n          \n          Updates of the International Standards for Neurologic Classification of Spinal Cord Injury: 2015 and 2019.\n\t\t\t\t\tPhys Med Rehabil Clin N Am.\n\t\t\t\t\t2020;\n\t\t\t\t\t31:\n\t\t\t\t\t319\u2013\n\t\t\t\t\t330."},{"key":"i1945-5763-28-4-33-b40","unstructured":"FIRMM - Framewise Integrated Real-time MRI Monitoring.\n          \n          \n            https:\/\/firmm.io\/. 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2.0)","volume":"52","year":"2014","unstructured":"Widerstr\u00f6m-Noga\n              E,\n            \n            \n              Biering-S\u00f8rensen\n              F,\n            \n            \n              Bryce\n              TN,\n            \n          \n          .\n\t\t\t\t\tThe International Spinal Cord Injury Pain Basic Data Set (version 2.0).\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2014;\n\t\t\t\t\t52:\n\t\t\t\t\t282\u2013\n\t\t\t\t\t286."},{"key":"i1945-5763-28-4-33-b43","series-title":"J Gen Intern Med","first-page":"606","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","year":"2001","unstructured":"Kroenke\n              K,\n            \n            \n              Spitzer\n              RL,\n            \n            \n              Williams\n              JB.\n            \n          \n          The PHQ-9: Validity of a brief depression severity measure.\n\t\t\t\t\tJ Gen Intern 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