Alterations in knee sensorimotor brain functional connectivity contributes to ACL injury in male high-school football players: a prospective neuroimaging analysis

Abstract

Objective: This study's purpose was to utilize a prospective dataset to examine differences in functional brain connectivity in male high school athletes who suffered an anterior cruciate ligament (ACL) injury relative to their non-injured peers.

Methods: Sixty-two male high school football players were evaluated using functional magnetic resonance imaging prior to their competitive season to evaluate resting-state functional brain connectivity. Three athletes later experienced an ACL injury and were matched to 12 teammates who did not go on to sustain an ACL injury (controls) based on school, age, height, weight, and year in school. Twenty-five knee-motor regions of interest (ROIs) were created to identify differences in connectivity between the two groups. Between-subject F and t tests were used to identify significant ROI differences using a false discovery rate correction for multiple comparisons.

Results: There was significantly less connectivity between the left secondary somatosensory cortex and the left supplementary motor area (p = 0.025), right pre-motor cortex (p = 0.026), right supplementary motor area (p = 0.026), left primary somatosensory cortex (superior division; p = 0.026), left primary somatosensory cortex (inferior division; p = 0.026), and left primary motor cortex (p = 0.048) for the ACL-injured compared to the control subjects. No other ROI-to-ROI comparisons were significantly different between the groups (all p > 0.05).

Conclusion: Our preliminary data indicate a potential sensorimotor disruption for male football players who go on to experience an ACL injury. Future studies with larger sample sizes and complementary measures of neuromuscular control are needed to support these findings.

Keywords: Central nervous system; Musculoskeletal injury; Resting-state fMRI.

Copyright © 2019 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Figures

Figure 1

Significantly less prospective connectivity between the left secondary somatosensory cortex (red circle) and six sensorimotor-related regions of interest (ROI; identified by colored circles in legend) between the participants with ACL injury and control participants. Each bar chart represents the individual fisher transformed Pearson correlation coefficients between the average residual BOLD time series between the left secondary somatosensory cortex and the respective ROI (noted by colored circles above each bar chart). All ROI-to-ROI results demonstrate significantly less connectivity for the ACL-injured participants (noted as ‘ACL’ in bar charts) relative to the controls. Brain is superior view. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)