Anterior cruciate ligament deficiency causes brain plasticity: a functional MRI study.
BACKGROUND
The mechanoreceptors located in anterior cruciate ligament (ACL) constitute an afferent source of information toward the central nervous system. It has been proposed that ACL deficiency causes a disturbance in neuromuscular control, affects central programs and consequently the motor response resulting in serious dysfunction of the injured limb.


OBJECTIVE
The objective of this study was to investigate whether chronic anterior cruciate ligament injury causes plastic changes in brain activation patterns.


METHODS
Case control study; Level of evidence, 3.


METHODS
Seventeen right leg-dominant male participants with chronic anterior cruciate ligament deficiency and 18 matched healthy male participants with no special sport or habitual physical activity participated in this study. Patient selection criteria comprised a complete right unilateral anterior cruciate ligament rupture > or = 6 months before testing. Brain activation was examined by using functional magnetic resonance imaging technique (1.5-T scanner).


RESULTS
Results show that patients with anterior cruciate ligament deficiency had diminished activation in several sensorimotor cortical areas and increased activation in 3 areas compared with controls: presupplementary motor area, posterior secondary somatosensory area, and posterior inferior temporal gyrus.


CONCLUSIONS
The current study reveals that anterior cruciate ligament deficiency can cause reorganization of the central nervous system, suggesting that such an injury might be regarded as a neurophysiologic dysfunction, not a simple peripheral musculoskeletal injury. This evidence could explain clinical symptoms that accompany this type of injury and lead to severe dysfunction. Understanding the pattern of brain activation after a peripheral joint injury such as anterior cruciate ligament injury lead to new standards in rehabilitation and motor control learning with a wide application in a number of clinical and research areas (eg, surgical procedures, patient re-education, athletic training, etc).
Kapreli
Eleni
E
Faculty of Physical Education and Sports Science, Laboratory of Sports Physiotherapy, National & Kapodistrian University of Athens, Greece. ekapreli@teilam.gr
Athanasopoulos
Spyros
S
Gliatis
John
J
Papathanasiou
Matilda
M
Peeters
Ronald
R
Strimpakos
Nikolaos
N
Van Hecke
Paul
P
Gouliamos
Athanasios
A
Sunaert
Stefan
S
D000328:Adult; D000070598:Anterior Cruciate Ligament Injuries; D001921:Brain / Q000502:physiology*; D002908:Chronic Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009473:Neuronal Plasticity / Q000502:physiology*; D011597:Psychomotor Performance / Q000502:physiology; D055815:Young Adult