Altered Brain Morphology In Women With History Of ACL Rupture: A Structural MRI Study

Abstract

Anterior cruciate ligament ruptures (ACLR) are among the most common musculoskeletal injuries in young women. Despite the presence of supraspinal alterations after ACLR, the global and localized morphological underpinnings have yet to be elucidated. PURPOSE: This study aimed to determine whether brain morphology differs in individuals with a history of ACLR compared to healthy controls with no history of injury. METHODS: Twenty (10 ACL, 10 controls) age- and physical activity-matched women (age: 20.9±2.9yr, weight: 65.9±8.8kg, height: 165.2±6.2cm) underwent 3T T1-weighted structural brain magnetic resonance imaging. Mean cortical thickness, grey matter and white matter volume were measured globally and within 70 and 95 anatomically defined regions of interest (ROIs), respectively. A two-way analysis of variance was used to determine differences in global and regional brain structure between ACL and controls, while correcting for multiple comparisons by controlling the false discovery rate. RESULTS: Mean duration since the completion of rehabilitation after ACLR was 3.1±1.1yr. Five injured the left leg and all but two participants were right foot dominant. Cortical thickness was significantly greater for controls in the left precentral gyrus (3.62±0.22 vs. 3.19±0.39mm, respectively P=0.019) and left paracentral lobule (3.70±0.23 vs. 3.27±0.26mm respectively; P=0.025). No differences in gray or white matter volume were seen for any of the ROIs between groups. CONCLUSION: Three years after ACL rupture, young women demonstrated persistent alterations in cortical thickness relative to individuals without a history of injury. Together with evidence of other supraspinal and neuromuscular deficits, this suggests cortical involvement in the ACLR pathological process. Thus, neurophysiological assessments should be considered in addition to traditional musculoskeletal measurements. Supported by a doctoral grant from the National Strength and Conditioning Association (SDF)