Deng Qian, Jin Guohua, Lou Xia, Ding Yuwu, Xu Haichen, Yang Kun, Liu Bingli, Jiang Liming
School of Health and Nursing, Wuxi Taihu University, Wuxi, China.
Department of Rehabilitation, Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Aging Neurosci. 2025 May 19;17:1589645. doi: 10.3389/fnagi.2025.1589645. eCollection 2025.
Knee osteoarthritis (KOA) is a chronic degenerative disease characterized primarily by pain and joint dysfunction, especially during level and stair walking. Although traditionally classified as a peripheral joint disease, emerging evidence implicates central nervous system (CNS) abnormality in KOA pathogenesis. Our previous studies found that KOA patients showed decreased activation in sensory-motor cortex during isolated joint movements. However, it is not yet clear how brain activation patterns change during level and stair walking. Therefore, this study will investigate the sensory-motor cortex activation in KOA patients during different walking environments, providing evidence for potential targets for KOA central interventions.
This study is designed as a cross-sectional observation, aiming to recruit 20 KOA patients and 20 demographically similar healthy controls (HC). Functional near-infrared spectroscopy (fNIRS) is utilized to assess the hemodynamic responses in the cerebral cortex within the specified regions of interest (ROIs), including the primary somatosensory cortex (S1), primary motor cortex (M1), and somatosensory association cortex (SAC). These measurements will be taken during three motor tasks: level walking, ascending stairs, and descending stairs. Simultaneously, surface electromyography (sEMG) is employed to measure muscle activity of the key muscle groups around the knee joint. The VAS and the WOMAC used to evaluate pain and functional symptoms in KOA patients, respectively. Subsequently, the potential correlations between cerebral hemodynamics changes within ROIs and clinical indicators are analyzed.
This study, based on "differential activation of the sensory-motor cortex under movement," innovatively observes the relationship between pain and functional impairment in KOA patients and activation levels in specific brain regions across different motor environments. This not only provides a basis for early prediction of KOA onset but also offers potential targets for clinical interventions in KOA. Ultimately, the results of this study may open new perspectives for the rehabilitation of chronic musculoskeletal diseases.
膝关节骨关节炎（KOA）是一种慢性退行性疾病，主要特征为疼痛和关节功能障碍，尤其是在平路行走和上下楼梯时。尽管传统上被归类为外周关节疾病，但新出现的证据表明中枢神经系统（CNS）异常参与了KOA的发病机制。我们之前的研究发现，KOA患者在孤立关节运动时感觉运动皮层的激活减少。然而，目前尚不清楚在平路行走和上下楼梯时大脑激活模式如何变化。因此，本研究将调查KOA患者在不同行走环境下感觉运动皮层的激活情况，为KOA中枢干预的潜在靶点提供证据。
本研究设计为横断面观察，旨在招募20例KOA患者和20例人口统计学特征相似的健康对照（HC）。利用功能近红外光谱（fNIRS）评估特定感兴趣区域（ROI）内大脑皮层的血流动力学反应，这些区域包括初级体感皮层（S1）、初级运动皮层（M1）和体感联合皮层（SAC）。这些测量将在三项运动任务期间进行：平路行走、上楼梯和下楼梯。同时，采用表面肌电图（sEMG）测量膝关节周围关键肌肉群的肌肉活动。VAS和WOMAC分别用于评估KOA患者的疼痛和功能症状。随后，分析ROI内脑血流动力学变化与临床指标之间的潜在相关性。
本研究基于“运动时感觉运动皮层的差异激活”，创新性地观察了KOA患者疼痛和功能损害与不同运动环境下特定脑区激活水平之间的关系。这不仅为KOA发病的早期预测提供了依据，也为KOA的临床干预提供了潜在靶点。最终，本研究结果可能为慢性肌肉骨骼疾病的康复开辟新的视角。
