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2.
Hum Brain Mapp ; 45(10): e26782, 2024 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-38989630

RESUMO

This study assesses the reliability of resting-state dynamic causal modelling (DCM) of magnetoencephalography (MEG) under conductance-based canonical microcircuit models, in terms of both posterior parameter estimates and model evidence. We use resting-state MEG data from two sessions, acquired 2 weeks apart, from a cohort with high between-subject variance arising from Alzheimer's disease. Our focus is not on the effect of disease, but on the reliability of the methods (as within-subject between-session agreement), which is crucial for future studies of disease progression and drug intervention. To assess the reliability of first-level DCMs, we compare model evidence associated with the covariance among subject-specific free energies (i.e., the 'quality' of the models) with versus without interclass correlations. We then used parametric empirical Bayes (PEB) to investigate the differences between the inferred DCM parameter probability distributions at the between subject level. Specifically, we examined the evidence for or against parameter differences (i) within-subject, within-session, and between-epochs; (ii) within-subject between-session; and (iii) within-site between-subjects, accommodating the conditional dependency among parameter estimates. We show that for data acquired close in time, and under similar circumstances, more than 95% of inferred DCM parameters are unlikely to differ, speaking to mutual predictability over sessions. Using PEB, we show a reciprocal relationship between a conventional definition of 'reliability' and the conditional dependency among inferred model parameters. Our analyses confirm the reliability and reproducibility of the conductance-based DCMs for resting-state neurophysiological data. In this respect, the implicit generative modelling is suitable for interventional and longitudinal studies of neurological and psychiatric disorders.


Assuntos
Doença de Alzheimer , Magnetoencefalografia , Humanos , Magnetoencefalografia/métodos , Magnetoencefalografia/normas , Reprodutibilidade dos Testes , Doença de Alzheimer/fisiopatologia , Masculino , Feminino , Idoso , Modelos Neurológicos , Teorema de Bayes
3.
Front Psychol ; 15: 1354719, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38887627

RESUMO

Flow has been described as a state of optimal performance, experienced universally across a broad range of domains: from art to athletics, gaming to writing. However, its phenomenal characteristics can, at first glance, be puzzling. Firstly, individuals in flow supposedly report a loss of self-awareness, even though they perform in a manner which seems to evince their agency and skill. Secondly, flow states are felt to be effortless, despite the prerequisite complexity of the tasks that engender them. In this paper, we unpick these features of flow, as well as others, through the active inference framework, which posits that action and perception are forms of active Bayesian inference directed at sustained self-organisation; i.e., the minimisation of variational free energy. We propose that the phenomenology of flow is rooted in the deployment of high precision weight over (i) the expected sensory consequences of action and (ii) beliefs about how action will sequentially unfold. This computational mechanism thus draws the embodied cognitive system to minimise the ensuing (i.e., expected) free energy through the exploitation of the pragmatic affordances at hand. Furthermore, given the challenging dynamics the flow-inducing situation presents, attention must be wholly focussed on the unfolding task whilst counterfactual planning is restricted, leading to the attested loss of the sense of self-as-object. This involves the inhibition of both the sense of self as a temporally extended object and higher-order, meta-cognitive forms of self-conceptualisation. Nevertheless, we stress that self-awareness is not entirely lost in flow. Rather, it is pre-reflective and bodily. Our approach to bodily-action-centred phenomenology can be applied to similar facets of seemingly agentive experience beyond canonical flow states, providing insights into the mechanisms of so-called selfless experiences, embodied expertise and wellbeing.

4.
Proc Natl Acad Sci U S A ; 121(26): e2402282121, 2024 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-38885383

RESUMO

Goal-directed actions are characterized by two main features: the content (i.e., the action goal) and the form, called vitality forms (VF) (i.e., how actions are executed). It is well established that both the action content and the capacity to understand the content of another's action are mediated by a network formed by a set of parietal and frontal brain areas. In contrast, the neural bases of action forms (e.g., gentle or rude actions) have not been characterized. However, there are now studies showing that the observation and execution of actions endowed with VF activate, in addition to the parieto-frontal network, the dorso-central insula (DCI). In the present study, we established-using dynamic causal modeling (DCM)-the direction of information flow during observation and execution of actions endowed with gentle and rude VF in the human brain. Based on previous fMRI studies, the selected nodes for the DCM comprised the posterior superior temporal sulcus (pSTS), the inferior parietal lobule (IPL), the premotor cortex (PM), and the DCI. Bayesian model comparison showed that, during action observation, two streams arose from pSTS: one toward IPL, concerning the action goal, and one toward DCI, concerning the action vitality forms. During action execution, two streams arose from PM: one toward IPL, concerning the action goal and one toward DCI concerning action vitality forms. This last finding opens an interesting question concerning the possibility to elicit VF in two distinct ways: cognitively (from PM to DCI) and affectively (from DCI to PM).


Assuntos
Mapeamento Encefálico , Objetivos , Imageamento por Ressonância Magnética , Humanos , Masculino , Feminino , Adulto , Rede Nervosa/fisiologia , Teorema de Bayes , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Lobo Parietal/fisiologia , Modelos Neurológicos , Adulto Jovem
5.
Front Psychol ; 15: 1345480, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38903472

RESUMO

While the ubiquity and importance of narratives for human adaptation is widely recognized, there is no integrative framework for understanding the roles of narrative in human adaptation. Research has identified several cognitive and social functions of narratives that are conducive to well-being and adaptation as well as to coordinated social practices and enculturation. In this paper, we characterize the cognitive and social functions of narratives in terms of active inference, to support the claim that one of the main adaptive functions of narrative is to generate more useful (i.e., accurate, parsimonious) predictions for the individual, as well as to coordinate group action (over multiple timescales) through shared predictions about collective behavior. Active inference is a theory that depicts the fundamental tendency of living organisms to adapt by proactively inferring the causes of their sensations (including their own actions). We review narrative research on identity, event segmentation, episodic memory, future projections, storytelling practices, enculturation, and master narratives. We show how this research dovetails with the active inference framework and propose an account of the cognitive and social functions of narrative that emphasizes that narratives are for the future-even when they are focused on recollecting or recounting the past. Understanding narratives as cognitive and cultural tools for mutual prediction in social contexts can guide research on narrative in adaptive behavior and psychopathology, based on a parsimonious mechanistic model of some of the basic adaptive functions of narrative.

7.
Synthese ; 203(5): 154, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38706520

RESUMO

Natural language syntax yields an unbounded array of hierarchically structured expressions. We claim that these are used in the service of active inference in accord with the free-energy principle (FEP). While conceptual advances alongside modelling and simulation work have attempted to connect speech segmentation and linguistic communication with the FEP, we extend this program to the underlying computations responsible for generating syntactic objects. We argue that recently proposed principles of economy in language design-such as "minimal search" criteria from theoretical syntax-adhere to the FEP. This affords a greater degree of explanatory power to the FEP-with respect to higher language functions-and offers linguistics a grounding in first principles with respect to computability. While we mostly focus on building new principled conceptual relations between syntax and the FEP, we also show through a sample of preliminary examples how both tree-geometric depth and a Kolmogorov complexity estimate (recruiting a Lempel-Ziv compression algorithm) can be used to accurately predict legal operations on syntactic workspaces, directly in line with formulations of variational free energy minimization. This is used to motivate a general principle of language design that we term Turing-Chomsky Compression (TCC). We use TCC to align concerns of linguists with the normative account of self-organization furnished by the FEP, by marshalling evidence from theoretical linguistics and psycholinguistics to ground core principles of efficient syntactic computation within active inference.

8.
World Psychiatry ; 23(2): 215-232, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38727058

RESUMO

Work at the intersection of philosophy and psychiatry has an extensive and influential history, and has received increased attention recently, with the emergence of professional associations and a growing literature. In this paper, we review key advances in work on philosophy and psychiatry, and their related clinical implications. First, in understanding and categorizing mental disorder, both naturalist and normativist considerations are now viewed as important - psychiatric constructs necessitate a consideration of both facts and values. At a conceptual level, this integrative view encourages moving away from strict scientism to soft naturalism, while in clinical practice this facilitates both evidence-based and values-based mental health care. Second, in considering the nature of psychiatric science, there is now increasing emphasis on a pluralist approach, including ontological, explanatory and value pluralism. Conceptually, a pluralist approach acknowledges the multi-level causal interactions that give rise to psychopathology, while clinically it emphasizes the importance of a broad range of "difference-makers", as well as a consideration of "lived experience" in both research and practice. Third, in considering a range of questions about the brain-mind, and how both somatic and psychic factors contribute to the development and maintenance of mental disorders, conceptual and empirical work on embodied cognition provides an increasingly valuable approach. Viewing the brain-mind as embodied, embedded and enactive offers a conceptual approach to the mind-body problem that facilitates the clinical integration of advances in both cognitive-affective neuroscience and phenomenological psychopathology.

9.
Lancet Neurol ; 23(6): 636-648, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38760101

RESUMO

Anthropogenic climate change is affecting people's health, including those with neurological and psychiatric diseases. Currently, making inferences about the effect of climate change on neurological and psychiatric diseases is challenging because of an overall sparsity of data, differing study methods, paucity of detail regarding disease subtypes, little consideration of the effect of individual and population genetics, and widely differing geographical locations with the potential for regional influences. However, evidence suggests that the incidence, prevalence, and severity of many nervous system conditions (eg, stroke, neurological infections, and some mental health disorders) can be affected by climate change. The data show broad and complex adverse effects, especially of temperature extremes to which people are unaccustomed and wide diurnal temperature fluctuations. Protective measures might be possible through local forecasting. Few studies project the future effects of climate change on brain health, hindering policy developments. Robust studies on the threats from changing climate for people who have, or are at risk of developing, disorders of the nervous system are urgently needed.


Assuntos
Mudança Climática , Doenças do Sistema Nervoso , Humanos , Doenças do Sistema Nervoso/epidemiologia
10.
Netw Neurosci ; 8(1): 24-43, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562283

RESUMO

A pervasive challenge in neuroscience is testing whether neuronal connectivity changes over time due to specific causes, such as stimuli, events, or clinical interventions. Recent hardware innovations and falling data storage costs enable longer, more naturalistic neuronal recordings. The implicit opportunity for understanding the self-organised brain calls for new analysis methods that link temporal scales: from the order of milliseconds over which neuronal dynamics evolve, to the order of minutes, days, or even years over which experimental observations unfold. This review article demonstrates how hierarchical generative models and Bayesian inference help to characterise neuronal activity across different time scales. Crucially, these methods go beyond describing statistical associations among observations and enable inference about underlying mechanisms. We offer an overview of fundamental concepts in state-space modeling and suggest a taxonomy for these methods. Additionally, we introduce key mathematical principles that underscore a separation of temporal scales, such as the slaving principle, and review Bayesian methods that are being used to test hypotheses about the brain with multiscale data. We hope that this review will serve as a useful primer for experimental and computational neuroscientists on the state of the art and current directions of travel in the complex systems modelling literature.

11.
Netw Neurosci ; 8(1): 178-202, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38562289

RESUMO

We present a didactic introduction to spectral dynamic causal modeling (DCM), a Bayesian state-space modeling approach used to infer effective connectivity from noninvasive neuroimaging data. Spectral DCM is currently the most widely applied DCM variant for resting-state functional MRI analysis. Our aim is to explain its technical foundations to an audience with limited expertise in state-space modeling and spectral data analysis. Particular attention will be paid to cross-spectral density, which is the most distinctive feature of spectral DCM and is closely related to functional connectivity, as measured by (zero-lag) Pearson correlations. In fact, the model parameters estimated by spectral DCM are those that best reproduce the cross-correlations between all measurements-at all time lags-including the zero-lag correlations that are usually interpreted as functional connectivity. We derive the functional connectivity matrix from the model equations and show how changing a single effective connectivity parameter can affect all pairwise correlations. To complicate matters, the pairs of brain regions showing the largest changes in functional connectivity do not necessarily coincide with those presenting the largest changes in effective connectivity. We discuss the implications and conclude with a comprehensive summary of the assumptions and limitations of spectral DCM.

12.
Proc Natl Acad Sci U S A ; 121(17): e2320239121, 2024 Apr 23.
Artigo em Inglês | MEDLINE | ID: mdl-38630721

RESUMO

Collective motion is ubiquitous in nature; groups of animals, such as fish, birds, and ungulates appear to move as a whole, exhibiting a rich behavioral repertoire that ranges from directed movement to milling to disordered swarming. Typically, such macroscopic patterns arise from decentralized, local interactions among constituent components (e.g., individual fish in a school). Preeminent models of this process describe individuals as self-propelled particles, subject to self-generated motion and "social forces" such as short-range repulsion and long-range attraction or alignment. However, organisms are not particles; they are probabilistic decision-makers. Here, we introduce an approach to modeling collective behavior based on active inference. This cognitive framework casts behavior as the consequence of a single imperative: to minimize surprise. We demonstrate that many empirically observed collective phenomena, including cohesion, milling, and directed motion, emerge naturally when considering behavior as driven by active Bayesian inference-without explicitly building behavioral rules or goals into individual agents. Furthermore, we show that active inference can recover and generalize the classical notion of social forces as agents attempt to suppress prediction errors that conflict with their expectations. By exploring the parameter space of the belief-based model, we reveal nontrivial relationships between the individual beliefs and group properties like polarization and the tendency to visit different collective states. We also explore how individual beliefs about uncertainty determine collective decision-making accuracy. Finally, we show how agents can update their generative model over time, resulting in groups that are collectively more sensitive to external fluctuations and encode information more robustly.


Assuntos
Comportamento de Massa , Modelos Biológicos , Animais , Teorema de Bayes , Movimento , Movimento (Física) , Peixes , Comportamento Social , Comportamento Animal
13.
Entropy (Basel) ; 26(4)2024 Mar 29.
Artigo em Inglês | MEDLINE | ID: mdl-38667857

RESUMO

In this paper, we unite concepts from Husserlian phenomenology, the active inference framework in theoretical biology, and category theory in mathematics to develop a comprehensive framework for understanding social action premised on shared goals. We begin with an overview of Husserlian phenomenology, focusing on aspects of inner time-consciousness, namely, retention, primal impression, and protention. We then review active inference as a formal approach to modeling agent behavior based on variational (approximate Bayesian) inference. Expanding upon Husserl's model of time consciousness, we consider collective goal-directed behavior, emphasizing shared protentions among agents and their connection to the shared generative models of active inference. This integrated framework aims to formalize shared goals in terms of shared protentions, and thereby shed light on the emergence of group intentionality. Building on this foundation, we incorporate mathematical tools from category theory, in particular, sheaf and topos theory, to furnish a mathematical image of individual and group interactions within a stochastic environment. Specifically, we employ morphisms between polynomial representations of individual agent models, allowing predictions not only of their own behaviors but also those of other agents and environmental responses. Sheaf and topos theory facilitates the construction of coherent agent worldviews and provides a way of representing consensus or shared understanding. We explore the emergence of shared protentions, bridging the phenomenology of temporal structure, multi-agent active inference systems, and category theory. Shared protentions are highlighted as pivotal for coordination and achieving common objectives. We conclude by acknowledging the intricacies stemming from stochastic systems and uncertainties in realizing shared goals.

14.
Phys Life Rev ; 49: 40-70, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38513522

RESUMO

A paradigmatic account may suffice to explain behavioral evolution in early Homo. We propose a parsimonious account that (1) could explain a particular, frequently-encountered, archeological outcome of behavior in early Homo - namely, the fashioning of a Paleolithic stone 'handaxe' - from a biological theoretic perspective informed by the free energy principle (FEP); and that (2) regards instances of the outcome as postdictive or retrodictive, circumstantial corroboration. Our proposal considers humankind evolving as a self-organizing biological ecosystem at a geological time-scale. We offer a narrative treatment of this self-organization in terms of the FEP. Specifically, we indicate how 'cognitive surprises' could underwrite an evolving propensity in early Homo to express sporadic unorthodox or anomalous behavior. This co-evolutionary propensity has left us a legacy of Paleolithic artifacts that is reminiscent of a 'snakes and ladders' board game of appearances, disappearances, and reappearances of particular archeological traces of Paleolithic behavior. When detected in the Early and Middle Pleistocene record, anthropologists and archeologists often imagine evidence of unusual or novel behavior in terms of early humankind ascending the rungs of a figurative phylogenetic 'ladder' - as if these corresponded to progressive evolution of cognitive abilities that enabled incremental achievements of increasingly innovative technical prowess, culminating in the cognitive ascendancy of Homo sapiens. The conjecture overlooks a plausible likelihood that behavior by an individual who was atypical among her conspecifics could have been disregarded in a community of Hominina (for definition see Appendix 1) that failed to recognize, imagine, or articulate potential advantages of adopting hitherto unorthodox behavior. Such failure, as well as diverse fortuitous demographic accidents, would cause exceptional personal behavior to be ignored and hence unremembered. It could disappear by a pitfall, down a 'snake', as it were, in the figurative evolutionary board game; thereby causing a discontinuity in the evolution of human behavior that presents like an evolutionary puzzle. The puzzle discomforts some paleoanthropologists trained in the natural and life sciences. They often dismiss it, explaining it away with such self-justifying conjectures as that, maybe, separate paleospecies of Homo differentially possessed different cognitive abilities, which, supposedly, could account for the presence or absence in the Pleistocene archeological record of traces of this or that behavioral outcome or skill. We argue that an alternative perspective - that inherits from the FEP and an individual's 'active inference' about its surroundings and of its own responses - affords a prosaic, deflationary, and parsimonious way to account for appearances, disappearances, and reappearances of particular behavioral outcomes and skills of early humankind.


Assuntos
Cognição , Hominidae , Humanos , Animais , Evolução Biológica , Paleontologia , Arqueologia , Fósseis
15.
Ann N Y Acad Sci ; 1534(1): 45-68, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38528782

RESUMO

This paper considers neural representation through the lens of active inference, a normative framework for understanding brain function. It delves into how living organisms employ generative models to minimize the discrepancy between predictions and observations (as scored with variational free energy). The ensuing analysis suggests that the brain learns generative models to navigate the world adaptively, not (or not solely) to understand it. Different living organisms may possess an array of generative models, spanning from those that support action-perception cycles to those that underwrite planning and imagination; namely, from explicit models that entail variables for predicting concurrent sensations, like objects, faces, or people-to action-oriented models that predict action outcomes. It then elucidates how generative models and belief dynamics might link to neural representation and the implications of different types of generative models for understanding an agent's cognitive capabilities in relation to its ecological niche. The paper concludes with open questions regarding the evolution of generative models and the development of advanced cognitive abilities-and the gradual transition from pragmatic to detached neural representations. The analysis on offer foregrounds the diverse roles that generative models play in cognitive processes and the evolution of neural representation.


Assuntos
Encéfalo , Cognição , Humanos , Sensação , Aprendizagem
16.
Sci Rep ; 14(1): 6641, 2024 03 19.
Artigo em Inglês | MEDLINE | ID: mdl-38503802

RESUMO

Cerebellar computations are necessary for fine behavioural control and may rely on internal models for estimation of behaviourally relevant states. Here, we propose that the central cerebellar function is to estimate how states interact with each other, and to use these estimates to coordinates extra-cerebellar neuronal dynamics underpinning a range of interconnected behaviours. To support this claim, we describe a cerebellar model for state estimation that includes state interactions, and link this model with the neuronal architecture and dynamics observed empirically. This is formalised using the free energy principle, which provides a dual perspective on a system in terms of both the dynamics of its physical-in this case neuronal-states, and the inferential process they entail. As a demonstration of this proposal, we simulate cerebellar-dependent synchronisation of whisking and respiration, which are known to be tightly coupled in rodents, as well as limb and tail coordination during locomotion. In summary, we propose that the ubiquitous involvement of the cerebellum in behaviour arises from its central role in precisely coupling behavioural domains.


Assuntos
Cerebelo , Locomoção , Cerebelo/fisiologia , Locomoção/fisiologia , Neurônios/fisiologia
17.
Bioengineering (Basel) ; 11(3)2024 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-38534498

RESUMO

There are considerable gaps in our understanding of the relationship between human brain activity measured at different temporal and spatial scales. Here, electrocorticography (ECoG) measures were used to predict functional MRI changes in the sensorimotor cortex in two brain states: at rest and during motor performance. The specificity of this relationship to spatial co-localisation of the two signals was also investigated. We acquired simultaneous ECoG-fMRI in the sensorimotor cortex of three patients with epilepsy. During motor activity, high gamma power was the only frequency band where the electrophysiological response was co-localised with fMRI measures across all subjects. The best model of fMRI changes across states was its principal components, a parsimonious description of the entire ECoG spectrogram. This model performed much better than any others that were based either on the classical frequency bands or on summary measures of cross-spectral changes. The region-specific fMRI signal is reflected in spatially and spectrally distributed EEG activity.

18.
Front Psychol ; 15: 1368265, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38510309

RESUMO

In the realm of law enforcement, the "police hunch" has long been a mysterious but crucial aspect of decision-making. Drawing on the developing framework of Active Inference from cognitive science, this theoretical article examines the genesis, mechanics, and implications of the police hunch. It argues that hunches - often vital in high-stakes situations - should not be described as mere intuitions, but as intricate products of our mind's generative models. These models, shaped by observations of the social world and assimilated and enacted through active inference, seek to reduce surprise and make hunches an indispensable tool for officers, in exactly the same way that hypotheses are indispensable for scientists. However, the predictive validity of hunches is influenced by a range of factors, including experience and bias, thus warranting critical examination of their reliability. This article not only explores the formation of police hunches but also provides practical insights for officers and researchers on how to harness the power of active inference to fully understand policing decisions and subsequently explore new avenues for future research.

19.
SN Appl Sci ; 6(2): 36, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38299095

RESUMO

We have investigated the theoretical constraints of the interactions between coupled cortical columns. Each cortical column consists of a set of neural populations where each population is modelled as a neural mass. The existence of semi-stable states within a cortical column is dependent on the type of interaction between the neuronal populations, i.e., the form of the synaptic kernels. Current-to-current coupling has been shown, in contrast to potential-to-current coupling, to create semi-stable states within a cortical column. The interaction between semi-stable states of the cortical columns is studied where we derive the dynamics for the collected activity. For small excitations the dynamics follow the Kuramoto model; however, in contrast to previous work we derive coupled equations between phase and amplitude dynamics with the possibility of defining connectivity as a stationary and dynamic variable. The turbulent flow of phase dynamics which occurs in networks of Kuramoto oscillators would indicate turbulent changes in dynamic connectivity for coupled cortical columns which is something that has been recorded in epileptic seizures. We used the results we derived to estimate a seizure propagation model which allowed for inversions using the Laplace assumption (Dynamic Causal Modelling). The seizure propagation model was trialed on simulated data, and future work will investigate the estimation of the connectivity matrix from empirical data. This model can be used to predict changes in seizure evolution after virtual changes in the connectivity network, something that could be of clinical use when applied to epilepsy surgical cases.

20.
Eur J Neurol ; 31(4): e16196, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38258488

RESUMO

BACKGROUND AND PURPOSE: In acute spinal cord injury (SCI), magnetic resonance imaging (MRI) reveals tissue bridges and neurodegeneration for 2 years. This 5-year study aims to track initial lesion changes, subsequent neurodegeneration, and their impact on recovery. METHODS: This prospective longitudinal study enrolled acute SCI patients and healthy controls who were assessed clinically-and by MRI-regularly from 3 days postinjury up to 60 months. We employed histologically cross-validated quantitative MRI sequences sensitive to volume, myelin, and iron changes, thereby reflecting indirectly processes of neurodegeneration and neuroinflammation. General linear models tracked lesion and remote changes in volume, myelin- and iron-sensitive magnetic resonance indices over 5 years. Associations between lesion, degeneration, and recovery (using the Spinal Cord Independence Measure [SCIM] questionnaire and the International Standards for Neurological Classification of Spinal Cord Injury total motor score) were assessed. RESULTS: Patients' motor scores improved by an average of 12.86 (95% confidence interval [CI] = 6.70-19.00) points, and SCIM by 26.08 (95% CI = 17.00-35.20) points. Within 3-28 days post-SCI, lesion size decreased by more than two-thirds (3 days: 302.52 ± 185.80 mm2 , 28 days: 76.77 ± 88.62 mm2 ), revealing tissue bridges. Cervical cord and corticospinal tract volumes transiently increased in SCI patients by 5% and 3%, respectively, accompanied by cervical myelin decreases and iron increases. Over time, progressive atrophy was observed in both regions, which was linked to early lesion dynamics. Tissue bridges, reduced swelling, and myelin content decreases were predictive of long-term motor score recovery and improved SCIM score. CONCLUSIONS: Studying acute changes and their impact on longer follow-up provides insights into SCI trajectory, highlighting the importance of acute intervention while indicating the potential to influence outcomes in the later stages.


Assuntos
Traumatismos da Medula Espinal , Humanos , Estudos Longitudinais , Estudos Prospectivos , Recuperação de Função Fisiológica , Traumatismos da Medula Espinal/complicações , Traumatismos da Medula Espinal/patologia , Traumatismos da Medula Espinal/reabilitação , Medula Espinal/patologia , Tratos Piramidais/patologia , Imageamento por Ressonância Magnética/métodos , Ferro
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