www.elsevier.com/locate/brainres Available online at www.sciencedirect.com Review Functional brain reorganization after spinal cord injury: Systematic review of animal and human studies Raffaele Nardone a,b,f,n , Yvonne Ho ¨ ller c,f , Francesco Brigo b,d , Martin Seidl a,f , Monica Christova e , Ju ¨ rgen Bergmann c , Stefan Golaszewski a,f , Eugen Trinka a,f a Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria b Department of Neurology, Franz Tappeiner Hospital, Merano, Italy c Neuroscience Institute & Center for Neurocognitive Research, Christian Doppler Klinik, Paracelsus Medical University, Salzburg, Austria d Department of Neurological, Neuropsychological, Morphological and Movement Sciences, Section of Clinical Neurology, University of Verona, Italy e Department of Physiology, Medical University of Graz, Graz, Austria f Spinal Cord Injury and Tissue Regeneration Center, Paracelsus Medical University, Salzburg, Austria article info Article history: Accepted 24 December 2012 Keywords: Spinal cord injury Functional magnetic resonance Transcranial magnetic stimulation Cortical reorganization Brain plasticity abstract Plastic changes of neural circuits occur after spinal cord injury (SCI) at various level of the central nervous system. In this review we will focus on delineating the pathophysiological mechanisms of the brain plasticity changes following SCI, based on the existing neuroi- maging and neurophysiological evidence in experimental models and humans. In animal experiments, reorganization of the sensory topography as well as of the topographical map of primary motor and premotor cortices have been reported in several studies. Brain imaging revealed that cortical representation in response to spared forelimb stimulation early enlarges and invades adjacent sensory-deprived hind limb territory. Electrophysio- logical studies demonstrated that the deafferentation due to SCI can immediately change the state of large cortical networks within 1 h, and that these changes play a critical role in the functional reorganization after SCI. In humans neuroimaging also showed shifts of functional motor and sensory cortical representations that relate to the severity of SCI. In patients with cervical SCI, cortical forearm motor representations, as assessed by means of transcranial magnetic stimulation, may reorganize towards the intrinsic hand motor representation to maximize output to muscles of the impaired forearm. Excessive or aberrant reorganisation of cerebral cortex may also have pathological consequences, such as phantom sensations or neuropathic pain. Integrated neuroimaging and neurophysio- logical approaches may also lead to the development of new therapeutic strategies, which have the potential of enhancing sensorimotor recovery in patients with SCI. & 2013 Elsevier B.V. All rights reserved. 0006-8993/$ - see front matter & 2013 Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.brainres.2012.12.034 n Corresponding author at: Paracelsus Medical University, Department of Neurology, Via Rossini, 5 39012 Merano, BZ, Italy. Fax: þ39 473 264449. E-mail address: raffaele.nardone@asbmeran-o.it (R. Nardone). brain research ] ( ]]]] ) ]]] – ]]] Please cite this article as: Nardone, R., et al., Functional brain reorganization after spinal cord injury: Systematic review of animal and human studies. Brain Research (2013), http://dx.doi.org/10.1016/j.brainres.2012.12.034