ObjectiveTo explore the effect mechanism of rehabilitation therapy post incomplete spinal cord injury (ISCI) in the view of graph theoretic analysis of the whole brain regions by the means of resting state functional magnetic resonance imaging (rs-fMRI).MethodsPatients with ISCI admitted to the Department of Rehabilitation Medicine of Tsinghua University Affiliated Beijing Tsinghua Changgung Hospital from January 2017 to June 2020 were selected and healthy subjects recruited in the same period were also selected. The patients were given comprehensive rehabilitation treatment for 2 weeks, including physical therapy, functional electrical stimulation treadwheel, walking training, etc. Healthy subjects and patients before and after treatment course were examined by rs-fMRI. While patients were assessed using the motor and sensory scores of American Spinal Injury Association (ASIA), muscle tone assessment, pain assessment, Walking Index for spinal cord injury (WISCI) as well as the Spinal Cord Independence Measure (SCIM).ResultsA total of 23 ISCI patients and 22 healthy subjects were included. After 2 weeks of treatment, ASIA lower limb motor function scores (P<0.001), ASIA sensory scores (P=0.005), Visual Analogue Scale (VAS) (P=0.027), WISCI (P=0.005) and SCIM (P<0.001) scores of the patients were significantly improved compared with before treatment. Before treatment, compared with healthy subjects, ISCI patients had lower betweenness centrality (BC) in the brain regions of R38, lower local efficiency (LE) in L21, L22, L39, L41, L42, L44, L48, R22, R39 and lower weighted degree (WD) in L22, L39, L41, L44, L48, R22, R39. After treatment, compared with the healthy subjects, the BC of R5, R6, R7, AR111 and AL112 of ISCI patients increased and in R6 and AR94, the clustering coefficient increased. The LE and WD of L21 and R21 in ISCI patients after treatment were higher than those before treatment.ConclusionsThe functional analysis of the whole brain network based on graph analysis can sensitively reflect the changes of brain network remodeling in patients with ISCI. Spinal cord injury can cause the decline of graph theoretical attributes of the auditory center-related brain regions. After rehabilitation treatment, the sensorimotor cortex, auditory center and extravertebral brain regions information transmitting ability in the whole brain network are improved, suggesting that rehabilitation training may participate in brain function remodeling by activating the sensorimotor center and non-motor center-related brain regions.