Proprioception deficits in chronic ankle instability associated with structural and functional alternations in cerebellar vermis

Abstract

Purpose: Ankle proprioception deficits have been widely reported in patients with chronic ankle instability (CAI), but their central neuropathological mechanisms have not been fully discussed. So, we aimed to figure out whether the structural and functional features of the cerebellar vermis differed between patients with CAI and healthy controls, and are associated with proprioception deficits in patients.

Methods: Twenty- two patients and 25 control individuals were enrolled in a cross-sectional investigation. All participants underwent structural and resting-state functional magnetic resonance imaging scanning to calculate voxel-based morphometry (VBM) and fractional amplitude of low-frequency fluctuation (fALFF) of the vermis. Between-group comparisons of the ankle instability-related subregions of the vermis were performed. Correlation analyses were performed between the outcomes of the surviving subregions and the proprioceptive scores of the ankle inversion discrimination apparatus for landing test.

Results: The subregion of vermis IV/V survived the multiple comparison correction to reveal a lower VBM value in patients than in healthy controls (Cohen's d ​= ​−0.968). The patients also showed significantly higher fALFF (Cohen's d ​= ​0.666) in this subregion. After controlling the demographic features, the proprioceptive scores were significantly correlated with VBM (r ​= ​0.622) and fALFF values (r ​= ​−0.512) in the group of patients.

Conclusions: Patients with CAI have lower gray matter volume and higher activity intensity in the cerebellar vermis than healthy control. The more severe proprioception deficits were significantly associated with the vermal volume and activity, which might be able to facilitate future diagnoses and treatments for CAI.

Keywords

Ankle injuries / Proprioception / Cerebellar vermis / Magnetic resonance imaging

CRediT authorship contribution statement

Xiao'ao Xue: Writing - original draft, Formal analysis, Data curation, Conceptualization. Yuwen Zhang: Writing - original draft, Formal analysis, Data curation, Conceptualization. Le Yu: Writing - original draft, Formal analysis, Data curation, Conceptualization. Qianru Li: Writing - review & editing, Software, Methodology. Yiran Wang: Writing - review & editing, Visualization, Software. Zikun Wang: Writing - review & editing, Methodology. Shanshan Zheng: Writing - review & editing, Formal analysis. Yang Sun: Writing - review & editing, Supervision, Resources. He Wang: Writing - review & editing, Supervision, Funding acquisition. Yinghui Hua: Writing - review & editing, Supervision, Project administration, Funding acquisition.

Funding

This work was supported by the National Natural Science Foundation of China [grant numbers 82372492, 82072510], National Key R&D Program of China [grant numbers 2018YFC1312900], Shanghai Natural Science Foundation [grant numbers 20ZR1406400], Science and Technology Commission of Shanghai Municipality [grant numbers 22dz1204700].

Ethical approval statement

All procedures were conducted adequate understanding and written informed consent from the subjects. All research protocols were approved by the institutional research ethics committee of Huashan Hospital (No. 2016-314).

Declaration of competing interest

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Acknowledgements

The authors sincerely thank the subjects for their participation and support in this study. The authors would also like to gratefully acknowledge EditSprings (https://www.editsprings.com/) for the expert linguistic services provided, and Prof. Jia Han for his series of high-quality studies on ankle proprioception that played as the guideline for the work of the first author.

Appendix A. Supplementary data

Supplementary data to this article can be found online at https://doi.org/10.1016/j.smhs.2024.11.006.

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