Cortical Activation During Visual Illusory Walking in Persons With Spinal Cord Injury: A Pilot Study
Open accessAbstract
Objective To 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.Design Pilot experimental functional magnetic resonance imaging (fMRI) trial.Setting Outpatient rehabilitation clinic.Participants Persons with paraplegia (n=3) and able-bodied participants (n=5) were included in this study.Interventions Not applicable.Main outcome measure Cortical activation as measured by the blood oxygenation level-dependent method of fMRI.Results During 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.Conclusions Treatment 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.
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In some studies, a mirror was used with a video projection of walking legs; in others, walking stimuli consisted of a video of an actor in first-person view walking along a path; and in another, participants viewed their virtual arms and legs in first person view in a virtual world through a head-mounted display.
“In some studies, a mirror was used with a video projection of walking legs [7, 15–17], in others the walking stimuli consisted of a video of an actor, in first-person view, walking along a path [18, 19] and in the last one participants viewed their virtual arms and legs in first person view in a virtual world through a head-mounted display [20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [18]
Third-person perspective has already been described, while first-person perspective was also applied.
“Third-person perspective has already been described [7], [15–17], while first-person perspective was also applied [18–20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [18]
The different studies regarding VW did not discuss therapy adherence.
“The different studies regarding VW did not discuss therapy adherence [7, 15–20].”
From Virtual walking therapy in neuropathic spinal cord injury pain: a feasibility study (2024) · cites this paper as [18]
The Methods (Visual illusory walking) describe the study’s simulated-walking procedure, and the Discussion (Limitations) says its aim was to examine cortical activation. Neither passage addresses therapy adherence or states whether other visual-walking studies discussed it; a search for adherence, compliance, attendance, and treatment sessions found no relevant passage in our copy. (LLM, conf=0.72)
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Cites
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Virtual reality for spinal cord injury-associated neuropathic pain: Systematic review
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Self-citationVirtual walking therapy in neuropathic spinal cord injury pain: a feasibility study
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“To draw conclusions about the effectiveness and therapeutic outcome on pain a further study with more patients is needed.”
Background
- Authors
- Eick, J., & Richardson, E. J.
- Affiliations
- University of Alabama at Birmingham (US)
- Corresponding author
- Richardson, Elizabeth J.
- Venue
- Archives of Physical Medicine and Rehabilitation
- Publisher
- Elsevier BV
- Published
- 2015-04
- Volume
- 96
- Issue
- 4
- Pages
- 750-753
- ISSN
- 0003-9993 (ISSN-L)
- PMC
- PMC4380793
- OpenAlex
- W2024672511
- Cited by
- 18
- References
- 14
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 4 · 2023: 2 · 2022: 2 · 2021: 1 · 2019: 1 · 2018: 2 · 2017: 1 · 2015: 1
- FWCI
- 0.49
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Archives of Physical Medicine and Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Disability and Rehabilitation Research (H133N110008)
- National Institutes of Health (1 K23 HD073680-01A1)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Physical Sciences › Computer Science › Human-Computer Interaction › Virtual Reality Applications and Impacts
- Keywords
- spinal cord injury, neuropathic pain, somatosensory cortex, cortical activation, paraplegia, sensory reorganization, virtual walking, pain management
- MeSH terms
- Adult, Cerebral Cortex, Female, Humans, Magnetic Resonance Imaging, Male, Neuralgia, Pain Measurement, Paraplegia, Pilot Projects, Somatosensory Cortex, Spinal Cord Injuries, Walking
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