Imagined movements in spinal cord injury pain patients improves pain and restores cortical activation patterns to normal

A recent study (reported at IASP 2010 in Montreal) enrolled 13 patients with pain below the level of spinal cord injury into a 6-week training program employing 30 mins of imagined movements and sensation in painful limbs every day. Participants kept daily pain diaries and functional MRI (fMRI) scanning was performed both before and after the training program. Healthy controls were also scanned at baseline for comparison purposes.

The fMRI scan below shows activity in normal subjects in response to executed movement of the right hand. Activity is primarily in the primary motor and somatosensory cortices and supplementary motor area.

This next image shows brain activity in response to the same movement in spinal cord injury patients before imagery training. Notice that activity in motor circuits is considerably lower compared to normals.

This final image shows brain activity in the same spinal cord injury patients after the 6-wk mental imagery program. The activation maps look very similar to the healthy controls, with activity in the motor pathways.