Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
J Athl Train. 2024 Sep 1;59(9):925-933. doi: 10.4085/1062-6050-0257.23.
The supplementary motor area (SMA) is involved in the functional deficits of chronic ankle instability (CAI), but the structural basis of its abnormalities remains unclear.
To determine the differences in volume- and surface-based morphologic features of the SMA between patients with CAI and healthy controls and the relationship between these features and the clinical features of CAI.
Cross-sectional study.
Sports medicine laboratory.
A total of 32 patients with CAI (10 women, 22 men; age = 32.46 ± 7.51 years) and 31 healthy controls (12 women, 19 men; age = 29.70 ± 8.07 years) participated.
MAIN OUTCOME MEASURE(S): We performed T1-weighted structural magnetic resonance imaging of participants and calculated volume- and surface-based morphologic features of SMA subregions. These subregions included anterior and posterior subdivisions of the medial portion of Brodmann area 6 (6 ma and 6 mp, respectively) and supplementary and cingulate eye fields. Between-group comparisons and correlation analysis with clinical features of CAI were performed.
Moderately thinner 6 mp (motor-output site; Cohen d = -0.61; 95% CI = -1.11, -0.10; P = .02) and moderately plainer 6 ma (motor-planning site; Cohen d = -0.70; 95% CI = -1.20, -0.19; P = .01) were observed in the CAI than the control group. A thinner 6 mp was correlated with lower Foot and Ankle Ability Measure Activities of Daily Living subscale scores before (r = 0.400, P = .02) and after (r = 0.449, P = .01) controlling for covariates.
Patients with CAI had a thinner 6 mp and a plainer 6 ma in the SMA compared with controls. The thin motor-output site of the SMA was associated with ankle dysfunction in patients. This morphologic evidence of maladaptive neuroplasticity in the SMA might promote more targeted rehabilitation of CAI.
补充运动区（SMA）与慢性踝关节不稳定（CAI）的功能障碍有关，但其异常的结构基础仍不清楚。
确定 CAI 患者与健康对照组之间 SMA 的基于体积和基于表面的形态特征差异，以及这些特征与 CAI 临床特征之间的关系。
横断面研究。
运动医学实验室。
共有 32 名 CAI 患者（10 名女性，22 名男性；年龄=32.46±7.51 岁）和 31 名健康对照组（12 名女性，19 名男性；年龄=29.70±8.07 岁）参与了研究。
对参与者进行 T1 加权结构磁共振成像，并计算 SMA 亚区的基于体积和基于表面的形态特征。这些亚区包括 Brodmann 区 6 的内侧部分的前、后部分（分别为 6ma 和 6mp）以及补充和扣带眼区。对组间比较和与 CAI 临床特征的相关性分析进行了分析。
与对照组相比，CAI 组的 6mp（运动输出部位）明显变薄（Cohen d=-0.61；95%CI=-1.11，-0.10；P=0.02），6ma（运动规划部位）明显变平（Cohen d=-0.70；95%CI=-1.20，-0.19；P=0.01）。6mp 变薄与 Foot and Ankle Ability Measure 日常生活活动分量表评分较低相关，包括控制协变量前后（r=0.400，P=0.02）。
与对照组相比，CAI 患者的 SMA 中的 6mp 变薄，6ma 变平。SMA 的运动输出部位变薄与患者的踝关节功能障碍有关。SMA 中这种适应不良的神经可塑性的形态学证据可能会促进更有针对性的 CAI 康复。
