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However, little is known about whether somatotopically specific representations can be activated despite reduced or absent afferent hand inputs. In this observational study, we used functional MRI and a (attempted) finger movement task in tetraplegic patients to characterise the somatotopic hand layout in primary somatosensory cortex. We further used structural MRI to assess spared spinal tissue bridges. We found that somatotopic hand representations can be activated through attempted finger movements in the absence of sensory and motor hand functioning, and no spared spinal tissue bridges. Such preserved hand somatotopy could be exploited by rehabilitation approaches that aim to establish new hand-brain functional connections after SCI (e.g. neuroprosthetics). However, over years since SCI the hand representation somatotopy deteriorated, suggesting that somatotopic hand representations are more easily targeted within the first years after SCI.<\/jats:p>","DOI":"10.7554\/elife.67713","type":"journal-article","created":{"date-parts":[[2021,10,19]],"date-time":"2021-10-19T08:10:11Z","timestamp":1634631011000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.67713","source":"Crossref","is-referenced-by-count":48,"title":["Finger somatotopy is preserved after tetraplegia but deteriorates over time"],"prefix":"10.7554","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9952-4864","authenticated-orcid":true,"given":"Sanne","family":"Kikkert","sequence":"first","affiliation":[{"name":"Neural Control of Movement Laboratory, Department of Health Sciences and Technology, ETH Z\u00fcrich, Z\u00fcrich, Switzerland"},{"name":"Spinal Cord Injury Center, Balgrist University Hospital, University of Z\u00fcrich, Z\u00fcrich, 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