Spinal Cord Injuries (SCI)
Conditions
Keywords
spinal cord injury, embodiment, bodily sensations, magnetic resonance imaging, daily life
Brief summary
Spinal cord injury (SCI) occurs when trauma or other factors damage the spinal cord, disrupting the flow of sensory information from the body to the brain. This interruption can interfere with embodiment-the body awareness and physical sensations processed by the brain-sometimes leading to a phenomenon called disembodiment. For people with SCI, disembodiment may appear as unusual body sensations, like feeling that a limb is in a different position than it actually is. Such changes in body awareness can impact daily life, mental health, and rehabilitation outcomes. Despite its importance, the study of embodiment in SCI remains limited. This project aims to explore how SCI alters embodiment, focusing on its specific characteristics, the effects on daily life, and the underlying brain activity as measured by functional magnetic resonance imaging (fMRI). Both people with and without SCI will participate. Procedure: Participants will complete a single examination lasting 2 to 2.5 hours, including approximately 55 minutes in the MRI scanner (with preparation and follow-up).
Interventions
BEHAVIORALBehavioral assessment
A comprehensive behavioral assessment of embodiment and its effect on daily living, taking into account pain, interoception, emotions and anxiety, sleep quality, life satsfaction and cognition.
BEHAVIORALFunctional Magnetic Resonance Imaging (fMRI)
Neural mechanisms of embodiments will be explored with MRI sequences including structural MRI, resting-state and task-based fMRI of the head. The task will be a modified version of the rubber hand illusion, previously used to asess embodiment. Participants will be required to lay in the MRI with their legs bended upright and a screen placed at the level of their hips, which will show a pair of legs. The participant's leg will be stroked with a paintbrush while the image on the screen will be showing the virtual legs being stroked. Participants will be required to report how strongly they perceive the virtual legs as their own, as a measure of embodiment.
Sponsors
Swiss Paraplegic Research, Nottwil
Study design
Observational model
CASE_CONTROL
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 65 Years
Healthy volunteers
Yes
Inclusion criteria
for all participants: * Age between 18 and 60 * Normal or corrected-to-normal visual acuity * German or Italian native speaker Additional Inclusion Criteria only for individuals with SCI: * Diagnosis of traumatic spinal cord injury * Lesion level below T1 (first thoracic vertebra) * Time since injury \>= 12 months * Residual sensation on the upper leg (sensory capability of 1 or higher on at least one leg in the dermatomes L2 and L3 for both light touch and pin prick).
Exclusion criteria
for all participants: * Pregnancy or breastfeeding * Diagnosis of other psychiatric or neurological disorders (e.g. epilepsy, tumor in the central nervous system) * Confirmed diagnosis of alcohol and/or drug abuse with active consumption within the last 6 months * Confirmed diagnosis of traumatic brain injury, intended as visible changes in the brain diagnosed by a radiologist * Stroke * Inability to perform study procedures (e.g. inability to consent) Additional
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Score on the Body Feelings and Illusions questionnaire (BoFI) | Baseline | A questionnaires that assess different dimensions of embodiment and disembodiment. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Strenght of the embodiment illusion | Baseline | Strenght of the embodiment illusion during the fMRI procedures, measured through a Likert scale. |
| Qualitative assessment of embodiment | Baseline | Qualitative assessment of the experience of embodiment by means of a semi-structured interview. |
| Score on the WHO Disability Assessment Scale (WHODAS-II) | Baseline | A scale that assesses activity limitation and participation restriction in the daily life due to disability. |
| Pain severity | Baseline | Intensity of pain measured on a visual analogue scale. |
| Score on the Positive and Negative Affect Schedule (PANAS) | Baseline | A scale which measures positive and negative sensations over the course of the last week. |
| Anxiety score on the Hospital Anxiety and Depression Scale (HADS) | Baseline | A scale the assesses the presence and the intensity of anxiety and depressive symptoms. |
| Depression score on the Hospital Anxiety and Depression Scale (HADS) | Baseline | A scale the assesses the presence and the intensity of anxiety and depressive symptoms. |
| Brain activity | Baseline | Brain activity defined as changes in oxygen levels in the blood during the execution of the embodiment task, and at rest. |
| Score on the Multidimensional Assessment of Interoceptive Awareness (MAIA) | Baseline | A questionnaire assessing interoceptive awarness. |
| Score on the Inclusion of Others in the Self test (IOS) | Baseline | A questionnaire assessing the relationship of the individual self with other entities (e.g., the body, the famiy, the society). |
| Score on the Montreal Cognitive Assessment (MoCA) | Baseline | A test assessing cognitive functions such as memory, attention, language, and executive functions. |
| Score on the Satisfaction with Life Scale (SLS) | Baseline | A scale assessing satisfaction in life. |
| Motor symptoms severity | Baseline | Motor symptoms severity (from level A to E) based on the International Standards for Neurological Classification of spinal cord injury (ISNCSCI) |
| Demographics | Baseline | Demographic information such as age, sex and education level, as well as time since injury. |
| Score on the Pittsburgh Sleep Quality Index | Baseline | A questionnaire assessing the quality of sleep. |
Countries
Switzerland
Contacts
Primary ContactGiuseppe A. Zito, Dr.
Backup ContactNicola Brunello, MSc
Outcome results
None listed