A comprehensive review of the literature-to-date on functional magnetic resonance imaging\n(fMRI) of the spinal cord is presented. Spinal fMRI has been shown, over more than two decades\nof work, to be a reliable tool for detecting neural activity. We discuss 10 key points regarding the\nhistory, development, methods, and applications of spinal fMRI. Animal models have served a\nkey purpose for the development of spinal fMRI protocols and for experimental spinal cord injury\nstudies. Applications of spinal fMRI span from animal models across healthy and patient populations\nin humans using both task-based and resting-state paradigms. The literature also demonstrates\nclear trends in study design and acquisition methods, as the majority of studies follow a task-based,\nblock design paradigm, and utilize variations of single-shot fast spin-echo imaging methods. We,\ntherefore, discuss the similarities and differences of these to resting-state fMRI and gradient-echo\nEPI protocols. Although it is newly emerging, complex connectivity and network analysis is not\nonly possible, but has also been shown to be reliable and reproducible in the spinal cord for both\ntask-based and resting-state studies. Despite the technical challenges associated with spinal fMRI,\nthis review identifies reliable solutions that have been developed to overcome these challenges.
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