The Neural Correlates of Shoulder Apprehension: A Functional MRI Study.
Although shoulder apprehension is an established clinical finding and is important for the prevention of shoulder dislocation, how this subjective perception is evoked remains unclear. We elucidated the functional neuroplasticity associated with apprehension in patients with recurrent anterior shoulder instability (RSI) using functional magnetic resonance imaging (fMRI). Twelve healthy volunteers and 14 patients with right-sided RSI performed a motor imagery task and a passive shoulder motion task. Brain activity was compared between healthy participants and those with RSI and was correlated with the apprehension intensity reported by participants after each task. Compared to healthy volunteers, participants with RSI exhibited decreased brain activity in the motor network, but increased activity in the hippocampus and amygdala. During the passive motion task, participants with RSI exhibited decreased activity in the left premotor and primary motor/somatosensory areas. Furthermore, brain activity was correlated with apprehension intensity in the left amygdala and left thalamus during the motor imagery task (memory-induced), while a correlation between apprehension intensity and brain activity was found in the left prefrontal cortex during the passive motion task (instability-induced). Our findings provide insight into the pathophysiology of RSI by identifying its associated neural alterations. We elucidated that shoulder apprehension was induced by two different factors, namely instability and memory.
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Hitoshi
H
Shitara
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Daisuke
D
Shimoyama
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Tsuyoshi
T
Sasaki
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Noritaka
N
Hamano
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Tsuyoshi
T
Ichinose
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Atsushi
A
Yamamoto
Department of Physical Therapy, Takasaki University of Health and Welfare, Takasaki, Gunma, Japan.
Tsutomu
T
Kobayashi
Department of Orthopaedic Surgery, National Hospital Organization Takasaki General Medical Center, Takasaki, Gunma, Japan.
Toshihisa
T
Osawa
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Haku
H
Iizuka
Department of Advanced Neuroimaging, Integrative Brain Imaging Center, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan.
Takashi
T
Hanakawa
Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Yoshito
Y
Tsushima
Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
Kenji
K
Takagishi
D000328:Adult; D001921:Brain / Q000503:physiopathology*; D001931:Brain Mapping; D015986:Confounding Factors, Epidemiologic; D005260:Female; D019416:Head Movements; D006439:Hemodynamics; D006801:Humans; D019018:Imagery, Psychotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D009038:Motion; D012782:Shoulder / Q000503:physiopathology*; D013223:Statistics as Topic; D013647:Task Performance and Analysis; D055815:Young Adult