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Introducción: El sistema ventricular encefálico es muy complejo, y es especialmente difícil de comprender para los estudiantes de pregrado. Clásicamente, la anatomía ventricular puede enseñarse usando encéfalos cadavéricos, imágenes de tomografía o resonancia magnética. Presentamos nuestra experiencia con el uso de imágenes tridimensionales obtenidas mediante un sistema de neuronavegación. Material y métodos: Se obtuvieron imágenes de resonancia magnética de 3 pacientes. Las imágenes fueron introducidas en un sistema de neuronavegación y se reconstruyó específicamente el sistema ventricular encefálico y algunas estructuras gangliobasales. Posteriormente se solicitó la opinión de 38 estudiantes de pregrado que cursaban la materia neuroanatomía, sobre la utilidad de las imágenes en el estudio del sistema ventricular.Discusión: todas las imágenes obtenidas fueron de buena calidad, el 100% de los estudiantes manifestó que las imágenes eran muy útiles o esenciales para comprender cabalmente la anatomía ventricular. Conclusiones: el uso de imágenes obtenidas por un sistema de neuronavegación son útiles en la enseñanza de la anatomía del sistema ventricular encefálico. AIntroduction: Anatomy of cerebral ventricles is very complex. Classically, ventricular system anatomy has been taught employing cadaveric brains and CT or MRI images. We present 3D images of the ventricular system obtained by neuronavigation system and the results of its use in teaching anatomy of cerebral ventricles. Material and methods: Magnetic resonance images of three patients were obtained. These images were transferred to a neuronavigation system, and a 3D reconstruction of cerebral ventricles, were performed. Afterwards, 38 undergraduate students were required to give their opinion about how useful the images are in order to study the cerebral ventricles. Results: One hundred percent of the students agreed that the images were very useful or even essential to utterly comprehend the ventricular anatomy. Discussion: As other authors, we think that 3D images are very useful as a complement for teaching anatomy of cerebral ventricles. Conclusions: Employment of 3D images obtained in a computer system are useful for teaching the encephalic ventricular system anatomy, as a complementary tool.

Abstract In recent years, our group and others have reported multiple cases of consistent neurological recovery in people with spinal cord injury (SCI) following a protocol that integrates locomotion training with brain machine interfaces (BMI). The primary objective of this pilot study was to compare the neurological outcomes (motor, tactile, nociception, proprioception, and vibration) in both an intensive assisted locomotion training (LOC) and a neurorehabilitation protocol integrating assisted locomotion with a noninvasive brain–machine interface (L + BMI), virtual reality, and tactile feedback. We also investigated whether individuals with chronic-complete SCI could learn to perform leg motor imagery. We ran a parallel two-arm randomized pilot study; the experiments took place in São Paulo, Brazil. Eight adults sensorimotor-complete (AIS A) (all male) with chronic (> 6 months) traumatic spinal SCI participated in the protocol that was organized in two blocks of 14 weeks of training and an 8-week follow-up. The participants were allocated to either the LOC group (n = 4) or L + BMI group (n = 4) using block randomization (blinded outcome assessment). We show three important results: (i) locomotion training alone can induce some level of neurological recovery in sensorimotor-complete SCI, and (ii) the recovery rate is enhanced when such locomotion training is associated with BMI and tactile feedback (∆Mean Lower Extremity Motor score improvement for LOC = + 2.5, L + B = + 3.5; ∆Pinprick score: LOC = + 3.75, L + B = + 4.75 and ∆Tactile score LOC = + 4.75, L + B = + 9.5). (iii) Furthermore, we report that the BMI classifier accuracy was significantly above the chance level for all participants in L + B group. Our study shows potential for sensory and motor improvement in individuals with chronic complete SCI following a protocol with BMIs and locomotion therapy. We report no dropouts nor adverse events in both subgroups participating in the study, opening the possibility for a more definitive clinical trial with a larger cohort of people with SCI. Trial registration: http://www.ensaiosclinicos.gov.br/ identifier RBR-2pb8gq.

Spinal cord injury (SCI) induces severe deficiencies in sensory-motor and autonomic functions and has a significant negative impact on patients' quality of life. There is currently no systematic rehabilitation technique assuring recovery of the neurological impairments caused by a complete SCI. Here, we report significant clinical improvement in a group of seven chronic SCI patients (six AIS A, one AIS B) following a 28-month, multi-step protocol that combined training with non-invasive brain-machine interfaces, visuo-tactile feedback and assisted locomotion. All patients recovered significant levels of nociceptive sensation below their original SCI (up to 16 dermatomes, average 11 dermatomes), voluntary motor functions (lower-limbs muscle contractions plus multi-joint movements) and partial sensory function for several modalities (proprioception, tactile, pressure, vibration). Patients also recovered partial intestinal, urinary and sexual functions. By the end of the protocol, all patients had their AIS classification upgraded (six from AIS A to C, one from B to C). These improvements translated into significant changes in the patients' quality of life as measured by standardized psychological instruments. Reexamination of one patient that discontinued the protocol after 12 months of training showed that the 16-month break resulted in neurological stagnation and no reclassification. We suggest that our neurorehabilitation protocol, based uniquely on non-invasive technology (therefore necessitating no surgical operation), can become a promising therapy for patients diagnosed with severe paraplegia (AIS A, B), even at the chronic phase of their lesion.