Recovery from spinal cord injury and its attendant neurodegenerative processes can follow a complicated trajectory spanning several years after trauma, where the ensuing diaschisis (meaning "shocked throughout") affects the entire neuroaxis. With potential treatments targeting repair of the injured spinal cord, there is an imperative to improve clinical trial design and efficiency, optimise patient stratification in the context of disease heterogeneity and identify potential trial outcome measures. The ability to track trauma-induced structural changes across the neuroaxis provides the opportunity to quantify pathological processes driving diaschisis and recovery-related plasticity. During my talk I will present evidence of progressive volume and microstructural changes (myelin and iron content) following acute spinal cord injury using state-of-the-art computational anatomy and post-processing tools. Further I will show latest developments of high-resolution MRI sequences and optimized post-processing methods to assess at the voxel level spinal cord grey and white matter changes. Finally, I will outline an integrative framework, which attempts to identify subgroups of neurologic disorders beyond standard clinical phenotyping and to improve functional outcome with individualized treatment (i.e., precision neurology). This framework, franchised under the term Embodied Neurology, pays special emphasis on the reciprocal information flow between the body, spinal cord and brain. Spinal cord injury is a particularly interesting model in the context of EN as a focal traumatic lesion in the spinal cord has far reaching consequences in terms of both cortical reorganization at distant sites (cf. functional diaschisis) and the functional architecture within and beyond the spinal cord (cf. structural diaschisis). To establish EN there is a pressing need for further developments in neuroimaging with the aim to unify structural and functional biophysical models in order to link pathology to phenomenology with greater precision.
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