Body, action, and space representations in people affected by spinal cord injuries

Anecdotical reports concerning modifications of the perception of the body, space, and action following a spinal cord injury (SCI) are well known to professionals that have experienced with these patients as they can report body misperceptions (e.g., phantom limb or body loss), misrepresentations of space (e.g., body or limbs position, distance lengthening), changes in action representation (e.g., illusionary and phantom limb movement leading to muscular fatigue) (Cole, 2004; Conomy, 1973; Curt, Yengue, Hilti, & Brugger, 2011; Scandola et al., 2017). These sensations, linked to pain, the level of the lesion and the time passed since the lesion onset (Scandola, Aglioti, Avesani, et al., 2017), are symptoms of neuroplastic changes in areas related to the body, space, and action representation. A spinal cord interruption, especially when this is not developmental but acquired, abruptly changes the brain–body communication. This modification alters the balance between the body sensorial inputs, the signals sent toward it, and the brain activity, leading to abnormalities in cortical and subcortical activity. Consequently, the brain neuroplastically changes itself (Nardone et al., 2013) into brain networks that are involved in body, space, and action representations. Therefore, modifications in these cognitive functions are likely to occur. This chapter is organized as: a first section reviewing the main literature concerning neuroplastic modifications in SCI individuals, underlying those related to the body, space, or action representations, the following three sections will show the experimental outcomes from studies concerning these representations in SCI individuals, and a fourth section will highlight the experimental results showing the effects of rehabilitative trainings on these representations. Finally, a concluding section will present the main findings, interpretations, and connections.