Yu Le, Jin Zhengbiao, Xue Xiao'ao, Tao Weichu, Xu Xiaoyun, Xia Tian, Zhang Yuwen, Yu Wenwen, Wang Ru, Wang He, Hua Yinghui
Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China.
School of Exercise and Health, Shanghai University of Sport, China.
J Athl Train. 2025 Apr 1;60(4):279-287. doi: 10.4085/1062-6050-0380.23.
Structural evidence for corticospinal tract (CST) abnormality in patients with anterior cruciate ligament reconstruction (ACLR) compared with healthy controls and the relationships between CST structure and clinical features of the patients (eg, objective sensorimotor outcomes and postoperative duration) are lacking.
To investigate whether the structural features of the CST differ between patients with ACLR and healthy controls and are associated with clinical features in patients after ACLR.
Cross-sectional study.
Sports medicine laboratory.
A total of 26 patients who had undergone ACLR (age = 36.35 ± 6.39 years, height = 173.88 ± 5.97 cm, mass = 74.80 ± 10.61 kg) and 26 healthy controls (age = 32.85 ± 9.20 years, height = 173.35 ± 7.19 cm, mass = 72.88 ± 11.06 kg) participated.
MAIN OUTCOME MEASURE(S): Using the CST as the region of interest, we performed diffusion tensor imaging to measure the microstructure of white matter tracts. Between-groups comparisons and correlation analyses with clinical features in patients with ACLR were performed.
Patients with ACLR had moderately lower fractional anisotropy (Cohen d = -0.666; 95% CI = -1.221, -0.104; P = .01), lower axial diffusivity (Cohen d = -0.526; 95% CI = -1.077, 0.030; P = .03), higher radial diffusivity (RD; Cohen d = 0.514; 95% CI = -0.042, 1.064; P = .04), and smaller Y-Balance Test anterior-reach distance (Cohen d = -0.743; 95% CI = -1.302, -0.177; P = .005) compared with healthy controls. The RD values were correlated with the postoperative duration (r = 0.623, P < .001) after controlling for age, sex, and body mass index in patients with ACLR.
Patients with ACLR had impaired integrity (lower fractional anisotropy values and higher RD values) in the CST contralateral to the ACLR injured limb in comparison with healthy controls. Decreased integrity (higher RD) of the CST in patients was associated with longer postoperative duration, which hinted that impaired structural integrity of the CST may be a maladaptive process of neuroplasticity in ACLR.
与健康对照组相比，前交叉韧带重建（ACLR）患者的皮质脊髓束（CST）异常的结构证据以及CST结构与患者临床特征（如客观感觉运动结果和术后持续时间）之间的关系尚缺乏。
研究ACLR患者与健康对照组之间CST的结构特征是否存在差异，以及是否与ACLR术后患者的临床特征相关。
横断面研究。
运动医学实验室。
共有26例接受ACLR的患者（年龄=36.35±6.39岁，身高=173.88±5.97厘米，体重=74.80±10.61千克）和26名健康对照者（年龄=32.85±9.20岁，身高=173.35±7.19厘米，体重=72.88±11.06千克）参与。
以CST为感兴趣区域，我们进行了扩散张量成像以测量白质束的微观结构。进行了组间比较以及与ACLR患者临床特征的相关性分析。
与健康对照组相比，ACLR患者的各向异性分数略低（Cohen d=-0.666；95%CI=-1.221，-0.104；P=0.01），轴向扩散率较低（Cohen d=-0.526；95%CI=-1.077，0.030；P=0.03），径向扩散率（RD）较高（Cohen d=0.514；95%CI=-0.042，1.064；P=0.04），Y平衡测试前伸距离较小（Cohen d=-0.743；95%CI=-1.302，-0.177；P=0.005）。在控制ACLR患者的年龄、性别和体重指数后，RD值与术后持续时间相关（r=0.623，P<0.001）。
与健康对照组相比，ACLR患者ACLR损伤肢体对侧的CST完整性受损（各向异性分数值较低，RD值较高）。患者CST完整性降低（RD较高）与术后持续时间较长相关，这提示CST结构完整性受损可能是ACLR中神经可塑性的一种适应不良过程。
