■膝关节骨性关节炎(KOA)患者在休息时脑激活模式异常,但尚不清楚大脑激活模式在运动过程中如何变化。本研究旨在探讨KOA患者在膝关节等速运动过程中脑激活模式的改变,以及皮质活动变化与疼痛严重程度和功能障碍之间的相关性。
■招募了18名KOA患者和18名健康对照(HC),并以三种速度进行膝关节等速测试。用功能近红外光谱(fNIRS)检测原发性体感(S1)大脑皮质血流动力学变化,运动过程中感兴趣区域(ROI)的初级运动(M1)和体感联想皮层(SAC)。然后,我们评估了M1,S1和SAC值与西安大略省和麦克马斯特大学骨关节炎指数(WOMAC)和视觉模拟量表(VAS)评分之间的潜在相关性.
■结果表明,KOA患者膝关节伸展的峰值扭矩明显小于HC。对于HC,单侧膝关节运动激活双侧ROI。对侧激活占优势,表现出高度对侧激活的现象。对于KOA患者,左右大脑皮层的激活水平没有统计学差异,与HC相比,两侧显示较低的活化水平。进一步分析发现,KOA患者患膝对侧M1、S1、SAC明显低于HC,而同侧没有发现差异。此外,在180°/s的等速运动期间,KOA患者的VAS评分与对侧S1和M1值的激活水平呈负相关,WOMAC与对侧M1值的激活水平呈负相关。
■单侧膝关节运动过程中存在感觉运动皮层的对侧激活,但是在KOA患者中,这种对侧皮层激活被抑制。此外,KOA患者的临床疼痛和功能障碍与特定脑区的激活水平相关。这些发现可以提供对KOA脑科学的更好理解,并有望有助于该疾病的中央干预的发展。
UNASSIGNED: Abnormal brain activation patterns in patients with knee osteoarthritis (KOA) at rest have been revealed, but it is unclear how brain activation patterns change during movement. This study aimed to investigate the alterations in brain activation patterns in KOA patients during knee
isokinetic movement, and the correlation between cortical activity changes and pain severity and dysfunction.
UNASSIGNED: Eighteen patients with KOA and 18 healthy controls (HC) were recruited, and to performed the knee
isokinetic test with three speeds. Functional near-infrared spectroscopy (fNIRS) was used to detect the cerebral cortex hemodynamics changes of primary somatosensory (S1), primary motor (M1) and somatosensory association cortex (SAC) in the region of interest (ROI) during movement. Then, we evaluated potential correlations between M1, S1 and SAC values and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and visual analog scale (VAS) scores.
UNASSIGNED: The results showed that peak torque of knee extension in KOA patients was significantly smaller than that in HC. For HC, unilateral knee movement activated bilateral ROIs. The contralateral activation was dominant, showing the phenomenon of high contralateral activation. For KOA patients, there were no statistical difference in the activation level between the left and right of the cerebral cortex, with both sides showing lower activation levels compared to HC. Further analysis found that the contralateral M1, S1, and SAC of the affected knee in KOA patients were significantly lower than those in HC, while no difference was found on the ipsilateral side. Moreover, during
isokinetic movement at 180°/s, VAS score in KOA patients was negatively correlated with the activation level of the contralateral S1 and M1 values, and WOMAC was negatively correlated with the activation level of the contralateral M1 value.
UNASSIGNED: Contralateral activation of the sensorimotor cortex exists during unilateral knee movement, but in KOA patients, this contralateral cortical activation is suppressed. Furthermore, the clinical pain and dysfunction in KOA patients are associated with activation levels of specific brain regions. These findings can provide a better understanding of KOA brain science and are expected to contribute to the development of central intervention for the disease.