Recent advancements in neuroimaging have illustrated that anterior cruciate ligament (ACL) injuries could impact the central nervous system (CNS), causing neuroplastic changes in the brain beyond the traditionally understood biomechanical consequences. While most of previous functional magnetic resonance imaging (fMRI) studies have focused on localized cortical activity changes post-injury, emerging research has suggested disruptions in functional connectivity across the brain. However, these prior investigations, albeit pioneering, have been constrained by two limitations: a reliance on small-sample participant cohorts, often limited to two to three patients, potentially limiting the generalizability of findings, and an adherence to region of interest based analysis, which may overlook broader network interactions. To address these limitations, our study employed resting-state fMRI to assess whole-brain functional connectivity in 15 ACL-injured patients, comparing them to matched controls using two distinct network analysis methods. Using Network-Based Statistics, we identified widespread reductions in connectivity that spanned across multiple brain regions. Further modular connectivity analysis showed significant decreases in inter-modular connectivity between the sensorimotor and cerebellar modules, and intra-modular connectivity within the default-mode network in ACL-injured patients. Our results thus highlight a shift from localized disruptions to network-wide dysfunctions, suggesting that ACL injuries induce widespread CNS changes. This enhanced understanding has the potential to stimulate the development of strategies aiming to restore functional connectivity and improve recovery outcomes.

中文翻译：

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前交叉韧带损伤患者脑功能连接的改变

神经影像学的最新进展表明，前十字韧带 (ACL) 损伤可能会影响中枢神经系统 (CNS)，导致大脑神经塑性变化超出传统理解的生物力学后果。虽然之前的大多数功能磁共振成像 (fMRI) 研究都集中在损伤后局部皮层活动的变化，但新兴研究表明整个大脑的功能连接受到破坏。然而，这些先前的研究虽然具有开创性，但受到两个局限性的限制：依赖小样本参与者队列，通常仅限于两到三名患者，可能限制研究结果的普遍性，以及坚持基于感兴趣区域的分析，这可能会忽略更广泛的网络交互。为了解决这些局限性，我们的研究采用静息态 fMRI 来评估 15 名 ACL 损伤患者的全脑功能连接，并使用两种不同的网络分析方法将其与匹配对照进行比较。使用基于网络的统计数据，我们发现跨多个大脑区域的连接性普遍减少。进一步的模块连接分析显示，ACL 损伤患者的感觉运动模块和小脑模块之间的模块间连接以及默认模式网络内的模块内连接显着降低。因此，我们的结果强调了从局部破坏到网络范围功能障碍的转变，这表明 ACL 损伤会引起广泛的中枢神经系统变化。这种加深的理解有可能刺激旨在恢复功能连接和改善恢复结果的策略的制定。