Not Only in Sensorimotor Network: Local and Distant Cerebral Inherent Activity of Chronic Ankle Instability—A Resting-State fMRI Study

Abstract

BackgroundIncreasing evidence has proved that chronic ankle instability (CAI) is highly related to the central nervous system (CNS). However, it is still unclear about the inherent cerebral activity among the CAI patients.PurposeTo investigate the differences of intrinsic functional cerebral activity between the CAI patients and healthy controls (HCs) and further explore its correlation with clinical measurement in CAI patients.Materials and MethodsA total of 25 CAI patients and 39 HCs were enrolled in this study. Resting-state functional magnetic resonance imaging (rs-fMRI) was used to detect spontaneous cerebral activity. The metrics of amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF), and regional homogeneity (ReHo) of the two groups were compared by two-sample t-test. The brain regions that demonstrated altered functional metrics were selected as the regions of interest (ROIs). The functional connectivity (FC) was analyzed based on the ROIs. The Spearman correlation was calculated between rs-fMRI metrics and clinical scale scores.ResultsCompared with HCs, CAI patients showed higher ALFF and ReHo values in the right postcentral gyrus, the right precentral gyrus, and the right middle frontal gyrus, while lower fALFF values in the orbital-frontal cortex (OFC, p < 0.01 after correction). Increasing FC between the right precentral gyrus and the right postcentral gyrus while decreasing FC between the right precentral gyrus and the anterior cingulum cortex (ACC), the right middle frontal gyrus and the left middle temporal gyrus, and the OFC and left inferior parietal lobule (IPL) was observed. In addition, in the CAI group, the ReHo value negatively correlated with the Cumberland Ankle Instability Tool score in the right middle frontal gyrus (r = −0.52, p = 0.007).ConclusionThe CAI patients exhibited enhanced and more coherent regional inherent neuronal activity within the sensorimotor network while lower regional inherent activity in pain/emotion modulation related region. In addition, the information exchanges were stronger within the sensorimotor network while weaker between distant interhemispheric regions. Besides, the increased inherent activity in the right middle frontal gyrus was related to clinical severity. These findings may provide insights into the pathophysiological alteration in CNS among CAI patients.

Low Regional Homogeneity of Intrinsic Cerebellar Activity in Ankle Instability: An Externally Validated rs-fMRI Study

“…For example, if more coherence of the cerebellum is needed to stabilize the ankle when running than when resting, it might also be more challenging for patients with worse resting cerebellar coherence to meet the functional demand of running. Our findings on the correlation between the ReHo values and the self-reported feeling of instability intensity might also indicate its relationship with ankle instability, and the recent ReHo study on cerebral cortex also supported that the premotor cortex of the patients had to be more coherent to compensate for sensory deafferentation in ankle instability (15). For this mechanism, we tentatively surmise that the aforementioned joint deafferentation might influence cerebellar lobule VIIIb (reducing ReHo values), thereby causing a failure of appropriate motor output by cerebellar lobule VIIIb (presenting as functional instability).…”

“…In contrast to distant connectivity methods that explore the association between different regions, ReHo might be able to determine whether the cerebellum is a key region with abnormally organized neurons involved in ankle instability ( 13 , 14 ). Recently, Shen et al ( 15 ) also investigated the ReHo of patients with ankle instability, but only the cerebral cortex was studied, and the cerebellum was ignored. Because poor functional coherence was supposed to be maladaptive, we speculated that low cerebellar ReHo values could be observed in ankle instability, which might be a necessary addition to previous structural evidence to improve our understanding of maladaptive neuroplasticity in ankle instability ( 16 ).…”

Altered gray matter volume and functional connectivity in lung cancer patients with bone metastasis pain

“…In addition, the ROC results indicated that the MFG, right MTG, cerebelum_6_L, and left lingual gyrus might have discrimination ability between groups. Similarly, increasing evidence suggests that structural and functional alterations in the MFG and MTG are associated with the mechanisms of chronic pain (Huang et al, 2020; Shen et al, 2022). Based on this information, we speculate that brain structural and functional differences may affect multiple dimensions of pain processing, including sensory, emotion, cognitive, and motor function, further revealing the complexity of the pathophysiological mechanisms of bone metastasis pain.…”

The effects of laser acupuncture dosage at PC6 (Neiguan) on brain reactivity: a pilot resting-state fMRI study

“…Significant alterations in the FC between the OFC and the pre/postcentral gyrus have been documented in individuals with chronic ankle instability (CAI) ( Shen et al, 2022 ). In the CAI population, a comparative analysis against the healthy control group reveals increased FC between the pre/postcentral gyrus, the sensorimotor network; while a concomitant decrease in FC is observed between the OFC and ACC, which associated with emotion or pain processing ( Shen et al, 2022 ).…”