title: Microstructural integrity of the superior cerebellar peduncle is associated with an impaired proprioceptive weighting capacity in individuals with non-specific low back pain.
abstract: BACKGROUND
  Postural control is a complex sensorimotor task that requires an intact network of white matter connections. The ability to weight proprioceptive signals is crucial for postural control. However, research into central processing of proprioceptive signals for postural control is lacking. This is specifically of interest in individuals with non-specific low back pain (NSLBP), because impairments in postural control have been observed as possible underlying mechanisms of NSLBP. Therefore, the objective was to investigate potential differences in sensorimotor white matter microstructure between individuals with NSLBP and healthy controls, and to determine whether the alterations in individuals with NSLBP are associated with the capacity to weight proprioceptive signals for postural control.
  
  
  METHODS
  The contribution of proprioceptive signals from the ankle and back muscles to postural control was evaluated by local muscle vibration in 18 individuals with NSLBP and 18 healthy controls. Center of pressure displacement in response to muscle vibration was determined during upright standing on a stable and unstable support surface. Diffusion magnetic resonance imaging was applied to examine whether this proprioceptive contribution was associated with sensorimotor white matter microstructure.
  
  
  RESULTS
  Individuals with NSLBP showed a trend towards a reduced fractional anisotropy along the left superior cerebellar peduncle compared to healthy controls (p = 0.039). The impaired microstructural integrity of the superior cerebellar peduncle in individuals with NSLBP was significantly correlated with the response to ankle muscle vibration (p<0.003).
  
  
  CONCLUSIONS
  In individuals with NSLBP, a decreased integrity of the superior cerebellar peduncle was associated with an increased reliance on ankle muscle proprioception, even on unstable support surface, which implies an impaired proprioceptive weighting capacity. Our findings emphasize the importance of the superior cerebellar peduncle in proprioceptive weighting for postural control in individuals with NSLBP.
authors.affiliation: KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Madelon
authors.initials: M
authors.lastname: Pijnenburg
authors.affiliation: Department of Physical Therapy and Motor Rehabilitation, University of Ghent, Ghent, Belgium; Department of Movement and Sports Sciences, University of Ghent, Ghent, Belgium.
authors.forename: Karen
authors.initials: K
authors.lastname: Caeyenberghs
authors.affiliation: KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Lotte
authors.initials: L
authors.lastname: Janssens
authors.affiliation: KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Nina
authors.initials: N
authors.lastname: Goossens
authors.affiliation: KU Leuven Department of Kinesiology, University of Leuven, Leuven, Belgium.
authors.forename: Stephan P
authors.initials: SP
authors.lastname: Swinnen
authors.affiliation: KU Leuven Department of Imaging and Pathology, University of Leuven, Leuven, Belgium.
authors.forename: Stefan
authors.initials: S
authors.lastname: Sunaert
authors.affiliation: KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, Belgium.
authors.forename: Simon
authors.initials: S
authors.lastname: Brumagne
mesh_terms: D000328:Adult; D000842:Ankle / Q000502:physiology; D001835:Body Weight; D002490:Central Nervous System / Q000503:physiopathology; D002531:Cerebellum / Q000503:physiopathology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D018482:Muscle, Skeletal / Q000502:physiology*; D009417:Nerve Tissue / Q000503:physiopathology; D011187:Posture / Q000502:physiology; D011434:Proprioception / Q000502:physiology*; D014732:Vibration