Reorganization of the brain in spinal cord injury: a meta-analysis of functional MRI studies

  • Wenzhao Wang
  • Wei Xie
  • Qianqian Zhang
  • Lei Liu
  • Jian Liu
  • Song Zhou
  • Jixue Shi
  • Jianan Chen
  • Bin NingEmail author
Functional Neuroradiology



Reorganization of the brain is considered the key mechanism of functional recovery in patients after spinal cord injury (SCI). This meta-analysis assessed abnormal brain activation in SCI patients to understand the pattern of reorganization in the brain after SCI.


Functional magnetic resonance imaging (fMRI) studies that compared SCI patients with controls and were published before August 30, 2018, were extracted from the PubMed, Web of Science, and EMBASE databases. Voxel-wise whole-brain meta-analysis and region-of-interest meta-analysis of group differences were separately performed. Then, meta-regression analysis was conducted with several clinical characteristics as regressors.


Sixteen studies that met the inclusion criteria were identified. Compared with control individuals, SCI patients showed increased activation in the sensorimotor cortex in both whole-brain and region-of-interest (ROI) analyses. In addition, whole-brain meta-analysis revealed increased activation in the cerebellum, and this increase was positively correlated with lesion level and injury severity.


Our results demonstrated that reorganization occurred mainly in the sensorimotor system of the brain after SCI, implying that brain functions involved in sensorimotor demands can still be preserved in this condition. These findings provide opportunities for future studies in terms of therapeutic strategies and prognosis assessment.


Spinal cord injury (SCI) Functional magnetic resonance imaging (fMRI) Neuroimaging Reorganization Meta-analysis 



Grant support was provided by the National Natural Science Fund of China (No. 81771346;81874002), the Chinese Postdoctoral Science Foundation (No. 2015T80725), the Technology Research and Development Program of Jinan City (No. 201704133), the Natural Science Funds of Shandong Province (No.ZR2016HP41), Shandong Medical and Health Science and Technology Development Programs (No.2016WS0618), and Science and Technology Development Program of Taian City (No.201640576).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of Shandong University research committee and with the 1964 Helsinki Declaration and its later amendments.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Orthopedics, Shandong First Medical University/ West China HospitalSichuan UniversityChengduChina
  2. 2.Department Spinal SurgeryJinan Central Hospital Affiliated to Shandong UniversityJinanChina
  3. 3.Department Obstetrics and GynecologyThe Second Affiliated Hospital of Shandong First Medical UniversityTaianChina

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