Quadriceps muscle function following anterior cruciate ligament reconstruction: systemic differences in neural and morphological characteristics
Quadriceps muscle function following anterior cruciate ligament reconstruction: systemic differences in neural and morphological characteristics
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DOI：
10.1007/s00221-019-05499-x
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发表时间：
2019-05-01
影响因子：
2
通讯作者：
Lepley, Lindsey K.
中科院分区：
文献类型：
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作者：
Lepley, Adam S.;Grooms, Dustin R.;Lepley, Lindsey K.
前交叉韧带重建（ACLR）后股四头肌功能障碍很常见。缺乏考虑神经变化多样性以及股四头肌形态适应的数据。我们研究了 ACLR 参与者（n = 11，术后一个月：69.4 +/- 22.4）与性别、年龄、身高、体重、肢体优势和活动水平匹配的对照组相比，股四头肌神经和形态特征的双边差异。使用霍夫曼反射（H：M）评估脊髓反射兴奋性；使用经颅磁刺激通过主动运动阈值（AMT）和运动诱发电位（MEP）来量化皮质脊髓兴奋性。使用膝关节屈曲/伸展任务和功能磁共振成像（fMRI）来评估皮质激活。使用结构 MRI 量化肌肉体积。还收集了肌肉力量和患者报告的结果。 2x2 RM 方差分析用于评估组间差异。与对侧肢体和对照肢体相比，检测到较小的股四头肌体积（总体积、股直肌、股内侧肌和中间肌）和较低的力量。与对照组相比，ACLR 患者的疼痛和恐惧程度更高，膝关节功能水平更低。 H:M 没有观察到差异。与对照组相比，ACLR 个体表现出较高的双侧 AMT 和较小的受伤肢体 MEP。与对照组相比，ACLR 参与者在负责运动和疼痛处理的额叶区域表现出更大的激活，这与自我报告的疼痛相关。我们的结果表明，与对照组相比，ACLR 患者表现出系统性神经差异，同时观察到股四头肌体积较小、股四头肌无力和自我报告的功能障碍。
Quadriceps muscle dysfunction is common following anterior cruciate ligament reconstruction (ACLR). Data considering the diversity of neural changes, in-concert with morphological adaptations of the quadriceps muscle, are lacking. We investigated bilateral differences in neural and morphological characteristics of the quadriceps muscle in ACLR participants (n=11, month post-surgery: 69.4 +/- 22.4) compared to controls matched by sex, age, height, weight, limb dominance, and activity level. Spinal reflex excitability was assessed using Hoffmann reflexes (H:M); corticospinal excitability was quantified via active motor thresholds (AMT) and motor-evoked potentials (MEP) using transcranial magnetic stimulation. Cortical activation was assessed using a knee flexion/extension task with functional magnetic resonance imaging (fMRI). Muscle volume was quantified using structural MRI. Muscle strength and patient-reported outcomes were also collected. 2x2 RM ANOVAs were used to evaluate group differences. Smaller quadriceps muscle volume (total volume, rectus femoris, vastus medialis, and intermedius) and lower strength were detected compared to contralateral and control limbs. Individuals with ACLR reported higher levels of pain and fear and lower levels of knee function compared to controls. No differences were observed for H:M. ACLR individuals demonstrated higher AMT bilaterally and smaller MEPs in the injured limb, compared to the controls. ACLR participants demonstrated greater activation in frontal lobe areas responsible for motor and pain processing compared to controls, which were associated with self-reported pain. Our results suggest that individuals with ACLR demonstrate systemic neural differences compared to controls, which are observed concurrently with smaller quadriceps muscle volume, quadriceps muscle weakness, and self-reported dysfunction.