Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
Sports Health. 2024 Jan-Feb;16(1):38-46. doi: 10.1177/19417381231156544. Epub 2023 Mar 2.
Ankle sprain causes proprioceptor injuries and prolonged joint deafferentation, which might lead to maladaptive neuroplasticity in patients with chronic ankle instability (CAI), especially in the cerebellum. Previous studies have indicated the impairment of superior cerebellar peduncle (SCP), but the inferior cerebellar peduncle (ICP) and middle cerebellar peduncle (MCP) have not been fully analyzed.
The cerebellar peduncles of participants with CAI would have altered fractional anisotropy (FA) and orientation dispersion index (ODI) in comparison with healthy controls without ankle injury history. In addition, FA and ODI would be correlated with the duration or severity of the sensorimotor deficits in CAI.
Cross-sectional study.
Level 3.
A group of 27 participants with CAI and 26 healthy controls underwent diffusion-weighted imaging scanning, with the cerebellar peduncles as the regions of interest. The measures obtained by single-shell diffusion tensor imaging and the multishell neurite orientation dispersion and density imaging were used. Correlation analyses were performed to examine the potential relationship between the FA/ODI and both the normalized Y-balance scores and the durations of ankle instability.
The ipsilateral ICP of the injured ankle in participants with CAI showed significantly lower FA (Cohen 95% CI, -1.33 to -0.21; = 0.04) and marginally significant higher ODI (Cohen 95% CI, 0.10 to 1.20, = 0.08) when compared with the same measures in the control group, with the ODI being positively correlated with the duration of ankle instability ( = 0.42, = 0.03).
The ICP in participants with CAI exhibited impaired integrity and a trend of abnormally organized neurites in comparison with a healthy control group.
The impairments of ICP might be an ongoing part of the pathological process of CAI, having the potential to become a target for the diagnostic evaluation of this clinical entity.
踝关节扭伤会导致本体感受器损伤和关节去传入延长，这可能导致慢性踝关节不稳定（CAI）患者出现适应性神经重塑，尤其是在小脑。先前的研究表明上小脑脚（SCP）受损，但下小脑脚（ICP）和中小脑脚（MCP）尚未得到充分分析。
与无踝关节受伤史的健康对照组相比，CAI 患者的小脑脚的各向异性分数（FA）和方向分散指数（ODI）会发生改变。此外，FA 和 ODI 与 CAI 中感觉运动缺陷的持续时间或严重程度相关。
横断面研究。
3 级。
一组 27 名 CAI 患者和 26 名健康对照者接受了弥散加权成像扫描，以小脑脚为感兴趣区。采用单壳弥散张量成像和多壳神经纤维取向分散和密度成像获得测量值。进行相关性分析以检查 FA/ODI 与 Y 平衡评分的归一化值和踝关节不稳定的持续时间之间的潜在关系。
与对照组相比，CAI 患者受伤踝关节的对侧 ICP 的 FA 显著降低（Cohen 95%CI，-1.33 至-0.21； = 0.04），ODI 则略有升高（Cohen 95%CI，0.10 至 1.20， = 0.08），且 ODI 与踝关节不稳定的持续时间呈正相关（ = 0.42， = 0.03）。
与健康对照组相比，CAI 患者的 ICP 完整性受损，神经纤维排列异常。
ICP 的损伤可能是 CAI 病理过程的持续部分，有可能成为该临床实体诊断评估的一个靶点。
