The Evolution of Neuroimaging Technologies to Evaluate Neural Activity Related to Knee Pain and Injury Risk.

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2024-01-01 Epub Date: 2023-12-18 DOI:10.1007/s12178-023-09877-5
Christopher D Riehm, Taylor Zuleger, Jed A Diekfuss, Emilio Arellano, Gregory D Myer
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Abstract

Purpose of review: In this review, we present recent findings and advancements in the use of neuroimaging to evaluate neural activity relative to ACL injury risk and patellofemoral pain. In particular, we describe prior work using fMRI and EEG that demonstrate the value of these techniques as well as the necessity of continued development in this area. Our goal is to support future work by providing guidance for the successful application of neuroimaging techniques that most effectively expose pain and injury mechanisms.

Recent findings: Recent studies that utilized both fMRI and EEG indicate that athletes who are at risk for future ACL injury exhibit divergent brain activity both during active lower extremity movement and at rest. Such activity patterns are likely due to alterations to cognitive, visual, and attentional processes that manifest as coordination deficits during naturalistic movement that may result in higher risk of injury. Similarly, in individuals with PFP altered brain activity in a number of key regions is related to subjective pain judgements as well as measures of fear of movement. Although these findings may begin to allow objective pain assessment and identification, continued refinement is needed. One key limitation across both ACL and PFP related work is the restriction of movement during fMRI and EEG data collection, which drastically limits ecological validity. Given the lack of sufficient research using EEG and fMRI within a naturalistic setting, our recommendation is that researchers target the use of mobile, source localized EEG as a primary methodology for exposing neural mechanisms of ACL injury risk and PFP. Our contention is that this method provides an optimal balance of spatial and temporal resolution with ecological validity via naturalistic movement.

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评估与膝关节疼痛和受伤风险相关的神经活动的神经成像技术的发展。
综述的目的:在这篇综述中,我们介绍了使用神经成像技术评估与前交叉韧带损伤风险和髌股关节疼痛有关的神经活动的最新发现和进展。特别是,我们介绍了之前使用 fMRI 和 EEG 所做的工作,这些工作证明了这些技术的价值以及在这一领域继续发展的必要性。我们的目标是为成功应用神经成像技术提供指导,从而最有效地揭示疼痛和损伤机制,为未来的工作提供支持:最近利用 fMRI 和脑电图进行的研究表明,有前交叉韧带损伤风险的运动员在下肢主动运动和静止时都会表现出不同的大脑活动。这种活动模式可能是由于认知、视觉和注意力过程发生了改变,在自然运动时表现为协调障碍,从而可能导致更高的受伤风险。同样,PFP 患者一些关键区域的大脑活动改变与主观疼痛判断以及运动恐惧测量有关。尽管这些研究结果可以开始对疼痛进行客观评估和识别,但仍需继续完善。前交叉韧带损伤(ACL)和后交叉韧带损伤(PFP)相关研究的一个主要局限性是在采集 fMRI 和脑电图数据时限制了运动,这极大地限制了生态有效性。鉴于缺乏在自然环境中使用脑电图和 fMRI 的充分研究,我们建议研究人员将移动、源定位脑电图作为揭示前交叉韧带损伤风险和前交叉韧带功能障碍神经机制的主要方法。我们的论点是,这种方法通过自然运动提供了空间和时间分辨率与生态有效性之间的最佳平衡。
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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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