DOES BRAIN FUNCTIONAL CONNECTIVITY CONTRIBUTE TO MUSCULOSKELETAL INJURY? A PRELIMINARY PROSPECTIVE ANALYSIS OF A NEURAL BIOMARKER OF ACL INJURY RISK

Review written by Dr Bart Dingenen info

BACKGROUND & OBJECTIVE

Motor coordination errors leading to a non-contact ACL injury are hypothesized to result from failure of the nervous system to ensure proper muscle activation and positioning of the knee. Interestingly, evidence is emerging that the central nervous system reorganizes in response to peripheral musculoskeletal injuries, such as an anterior cruciate ligament (ACL) injury. Recent reports have found unresolved neuroplastic alterations after ACL injury and reconstruction that may contribute to persistent aberrant biomechanical patterns and re-injury risk. However, it is possible that altered neurologic patterns detected after injury were already present prior to the initial ACL injury. There is a paucity of data examining direct measures of central nervous system function prior to ACL injury.

The objective of this study was to evaluate prospectively differences in central nervous system function between participants who went on to suffer an ACL injury relative to matched teammates that did not get injured during their competitive season.

METHODS

72 female participants were enrolled in a prospective longitudinal neuroimaging study from two local high schools. Two athletes (16.0±0.0 years) experienced non-contact complete ACL tears during their competitive soccer season and were matched with eight athletes who did not sustain an ACL injury based on age, team, year in school, sex, height and weight. Magnetic resonance imaging (MRI) scans were completed prior to the soccer season for all participants. Participants were asked to flex and extend their knee in conjunction with an auditory metronome. Knee-motor regions of interest were created based on previously published knee-related fMRI data to determine neurological differences in brain connectivity related to knee motor control.

RESULTS

There was significantly lower connectivity between the left primary sensory cortex and the right posterior lobe of the cerebellum in the ACL-injured group compared to the control group.

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