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Maricot A, Dick E, Walravens A, Pluym B, Lathouwers E, De Pauw K, Verschueren J, Roelands B, Meeusen R, Tassignon B. Brain Neuroplasticity Related to Lateral Ankle Ligamentous Injuries: A Systematic Review. Sports Med 2023; 53:1423-1443. [PMID: 37155129 DOI: 10.1007/s40279-023-01834-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND Lateral ankle sprains are the most common ankle injuries in sports and have the highest recurrence rates. Almost half of the patients experiencing lateral ankle sprains develop chronic ankle instability. Patients with chronic ankle instability experience persistent ankle dysfunctions and detrimental long-term sequelae. Changes at the brain level are put forward to explain these undesirable consequences and high recurrence rates partially. However, an overview of possible brain adaptations related to lateral ankle sprains and chronic ankle instability is currently lacking. OBJECTIVE The primary purpose of this systematic review is to provide a comprehensive overview of the literature on structural and functional brain adaptations related to lateral ankle sprains and in patients with chronic ankle instability. METHODS PubMed, Web of Science, Scopus, Embase, EBSCO-SPORTDiscus and Cochrane Central Register of Controlled Trials were systematically searched until 14 December, 2022. Meta-analyses, systematic reviews and narrative reviews were excluded. Included studies investigated functional or structural brain adaptations in patients who experienced a lateral ankle sprain or with chronic ankle instability and who were at least 18 years of age. Lateral ankle sprains and chronic ankle instability were defined following the recommendation of the International Ankle Consortium. Three authors independently extracted the data. They extracted the authors' name, publication year, study design, inclusion criteria, participant characteristics, the sample size of the intervention and control groups, methods of neuroplasticity testing, as well as all means and standard deviations of primary and secondary neuroplasticity outcomes from each study. Data reported on copers were considered as part of the control group. The quality assessment tool for observational and cross-sectional studies was used for the risk of bias assessment. This study is registered on PROSPERO, number CRD42021281956. RESULTS Twenty articles were included, of which only one investigated individuals who experienced a lateral ankle sprain. In all studies combined, 356 patients with chronic ankle instability, 10 who experienced a lateral ankle sprain and 46 copers were included. White matter microstructure changes in the cerebellum have been related to lateral ankle sprains. Fifteen studies reported functional brain adaptations in patients with chronic ankle instability, and five articles found structural brain outcomes. Alterations in the sensorimotor network (precentral gyrus and supplementary motor area, postcentral gyrus and middle frontal gyrus) and dorsal anterior cingulate cortex were mainly found in patients with chronic ankle instability. DISCUSSION The included studies demonstrated structural and functional brain adaptations related to lateral ankle sprains and chronic ankle instability compared to healthy individuals or copers. These adaptations correlate with clinical outcomes (e.g. patients' self-reported function and different clinical assessments) and might contribute to the persisting dysfunctions, increased re-injury risk and long-term sequelae seen in these patients. Thus, rehabilitation programmes should integrate sensorimotor and motor control strategies to cope with neuroplasticity related to ligamentous ankle injuries.
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Affiliation(s)
- Alexandre Maricot
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Emilie Dick
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Annemiek Walravens
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bert Pluym
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Elke Lathouwers
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Kevin De Pauw
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Jo Verschueren
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bart Roelands
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Romain Meeusen
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium
- Brussels Human Robotics Research Center (BruBotics), Vrije Universiteit Brussel, 1050, Brussels, Belgium
| | - Bruno Tassignon
- Faculty of Physical Education and Physiotherapy, Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, 1050, Brussels, Belgium.
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Zhiznevskiy DV, Zamergrad MV, Levin OS, Azimova AA. [Bilateral peripheral vestibulopathy]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:24-30. [PMID: 37084361 DOI: 10.17116/jnevro202312304124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
Bilateral vestibulopathy is a relatively widespread and at the same time rarely diagnosed cause of chronic postural instability. Numerous toxic factors, dysmetabolic, autoimmune and neurodegenerative processes can lead to this condition. The main clinical manifestations of bilateral vestibulopathy are balance disorders and visual disturbances (oscillopsia), which can significantly increase the risks of falls in such patients. In addition, cognitive and affective disorders, which also reduce the quality of life in patients with bilateral vestibulopathy, have been described and actively studied in recent years. The diagnosis of bilateral vestibulopathy is based on the results of a clinical neurovestibular study, including a dynamic visual acuity test and a Halmagyi test. A video head impulse test, a bithermal caloric test and a sinusoidal rotation test are used as instrumental methods confirming the dysfunction of the peripheral vestibular system. However, they are still not widespread in neurological practice. Treatment of bilateral vestibulopathy is reduced to vestibular rehabilitation. Encouraging results have been obtained in a number of studies using galvanic vestibular stimulation and the use of vestibular implants. In addition, cognitive rehabilitation methods are currently being developed, which presumably can also improve compensation for bilateral vestibular loss.
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Affiliation(s)
- D V Zhiznevskiy
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - M V Zamergrad
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
- Russian Gerontology Clinical Research Center of Pirogov Russian National Research Medical University, Moscow, Russian
| | - O S Levin
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | - A A Azimova
- Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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McLaren R, Chaudhary S, Rashid U, Ravindran S, Taylor D. Reliability of the triangle completion test in the real-world and in virtual reality. Front Hum Neurosci 2022; 16:945953. [PMID: 36034112 PMCID: PMC9411518 DOI: 10.3389/fnhum.2022.945953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background The triangle completion test has been used to assess egocentric wayfinding for decades, yet there is little information on its reliability. We developed a virtual reality (VR) based test and investigated whether either test of spatial navigation was reliable. Objective To examine test-retest reliability of the real-world and VR triangle completion tests. A secondary objective was to examine the usability of the VR based test. Materials and methods Thirty healthy adults aged 18–45 years were recruited to this block randomized study. Participants completed two sessions of triangle completion tests in the real-world and VR on the same day with a break between sessions. Results In both test versions distance from the endpoint and angle of deviation showed poor test-retest reliability (r < 0.5). Distance traveled had moderate reliability in both the real-world and VR tests (r = 0.55 95% CI [0.23, 0.76]; r = 0.66 95% CI [0.4, 0.83, respectively]). The VR triangle test showed poor correlation with the real-world test. Conclusion The triangle completion test has poor test-retest reliability and demonstrates poor concurrent validity between the real-world and VR. Nevertheless, it was feasible to translate a real-world test of spatial navigation into VR. VR provides opportunities for development of clinically relevant spatial navigation tests in the future.
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Chronic, Mild Vestibulopathy Leads to Deficits in Spatial Tasks that Rely on Vestibular Input While Leaving Other Cognitive Functions and Brain Volumes Intact. Life (Basel) 2021; 11:life11121369. [PMID: 34947900 PMCID: PMC8707705 DOI: 10.3390/life11121369] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 11/30/2021] [Accepted: 12/07/2021] [Indexed: 02/07/2023] Open
Abstract
Objectives: In this study, based on the known vestibulo-hippocampal connections, we asked whether mild chronic vestibulopathy leads only to vestibular-related deficits or whether there are effects on hippocampal function, structure, and cognition in general. In more detail, we assessed whether chronic vestibulopathy leads to (a) deficits in vestibular tasks without cognitive demand (balancing), (b) deficits in spatial cognitive tasks that require vestibular input (path integration, rotational memory), (c) deficits in spatial cognitive tasks that do not rely on vestibular input, (d) deficits in general cognitive function, and (e) atrophy in the brain. Methods: A total of 15 patients with chronic uni- or bilateral vestibulopathy (56.8 ± 10.1 years; 4 females) were included in this study and were age- and gender-matched by the control participants (57.6 ± 10.5) in a pairwise manner. Given their clinical symptoms and their deficits of the vestibulo-ocular reflex (VOR) the patients could be classified as being mildly affected. All participants of the underwent the following tests: clinical balance (CBT), triangle completion (TCT) for path integration, rotational memory (RM), the visuo-spatial subset of the Berlin intelligence structure test (BIS-4) and d2-R for attention and concentration, and a structural MRI for gray matter analysis using voxel-based morphometry (VBM). Results: Compared to the healthy controls, the vestibulopathy patients performed significantly worse in terms of CBT, TCT, and RM but showed no differences in terms of the BIS-4 and d2-R. There were also no significant volumetric gray matter differences between the two groups. Conclusions: This study provides evidence that both non-cognitive and cognitive functions that rely on vestibular input (balancing, path integration, rotational memory) are impaired, even in mild chronic vestibulopathy, while other cognitive functions, which rely on visual input (visuo-spatial memory, attention), are unimpaired in this condition, together with an overall intact brain structure. These findings may reflect a segregation between vestibular- and visual-dependent processes in the medial temporal lobe on the one hand and a structure–function dissociation on the other.
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Seidel-Marzi O, Hähner S, Ragert P, Carius D. Task-Related Hemodynamic Response Alterations During Slacklining: An fNIRS Study in Advanced Slackliners. FRONTIERS IN NEUROERGONOMICS 2021; 2:644490. [PMID: 38235235 PMCID: PMC10790949 DOI: 10.3389/fnrgo.2021.644490] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/09/2021] [Indexed: 01/19/2024]
Abstract
The ability to maintain balance is based on various processes of motor control in complex neural networks of subcortical and cortical brain structures. However, knowledge on brain processing during the execution of whole-body balance tasks is still limited. In the present study, we investigated brain activity during slacklining, a task with a high demand on balance capabilities, which is frequently used as supplementary training in various sports disciplines as well as for lower extremity prevention and rehabilitation purposes in clinical settings. We assessed hemodynamic response alterations in sensorimotor brain areas using functional near-infrared spectroscopy (fNIRS) during standing (ST) and walking (WA) on a slackline in 16 advanced slackliners. We expected to observe task-related differences between both conditions as well as associations between cortical activity and slacklining experience. While our results revealed hemodynamic response alterations in sensorimotor brain regions such as primary motor cortex (M1), premotor cortex (PMC), and supplementary motor cortex (SMA) during both conditions, we did not observe differential effects between ST and WA nor associations between cortical activity and slacklining experience. In summary, these findings provide novel insights into brain processing during a whole-body balance task and its relation to balance expertise. As maintaining balance is considered an important prerequisite in daily life and crucial in the context of prevention and rehabilitation, future studies should extend these findings by quantifying brain processing during task execution on a whole-brain level.
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Affiliation(s)
- Oliver Seidel-Marzi
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Susanne Hähner
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Leipzig, Germany
| | - Patrick Ragert
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Leipzig, Germany
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Daniel Carius
- Institute for General Kinesiology and Exercise Science, Faculty of Sport Science, University of Leipzig, Leipzig, Germany
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Dordevic M, Gruber J, Schmitt FC, Mueller N. Impairments in path integration, rotational memory and balancing in patients with temporal lobe epilepsy. BMJ Neurol Open 2020; 2:e000077. [PMID: 33681800 PMCID: PMC7903167 DOI: 10.1136/bmjno-2020-000077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/17/2020] [Accepted: 08/23/2020] [Indexed: 11/08/2022] Open
Abstract
Objectives The vestibulo-medial temporal lobe (MTL) axis model proposes that the vestibular system and the MTL are tightly linked both structurally and functionally so that alterations of one structure should entail disturbances in the other. Accordingly, patients with temporal lobe epilepsy (TLE) with their functional and possible structural temporal lobe pathology should show deficits in vestibular-related behaviour. This study aimed at assessing behavioural deficits related to a suspected disturbance of the vestibulo-MTL axis in patients with TLE. Methods Twenty patients with TLE (46.7±15.1 years, seven females) and their age-matched and gender-matched controls (46.7±15.1, seven females) underwent three test batteries that challenged vestibular and MTL functions: balancing, path integration (triangle completion test) and rotational memory. In addition, participants underwent a structural MRI for grey matter analysis using voxel-based morphometry. Results Compared with controls, patients with TLE showed significantly inferior performance in all three behavioural tests, with large effect sizes. There were no significant grey matter differences between the two groups. Conclusion These results indicate a potential disturbance in the vestibulo-MTL axis in TLE; these are to be verified by future large-scale studies. In the current study, these behavioural deficits emerged without evidence of any brain volume differences between the patients and their controls as depicted by high-resolution MRI. This speaks for a dissociation between functional and structural alterations in TLE.
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Affiliation(s)
- Milos Dordevic
- Department of Neurology, Otto-von-Guericke-Universitat Magdeburg Medizinische Fakultät, Magdeburg, Sachsen-Anhalt, Germany.,DZNE, Magdeburg, Sachsen-Anhalt, Germany
| | | | - Friedhelm C Schmitt
- Department of Neurology, Otto-von-Guericke-Universitat Magdeburg Medizinische Fakultät, Magdeburg, Sachsen-Anhalt, Germany
| | - Notger Mueller
- Department of Neurology, Otto-von-Guericke-Universitat Magdeburg Medizinische Fakultät, Magdeburg, Sachsen-Anhalt, Germany.,DZNE, Magdeburg, Sachsen-Anhalt, Germany
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Müller P, Duderstadt Y, Lessmann V, Müller NG. Lactate and BDNF: Key Mediators of Exercise Induced Neuroplasticity? J Clin Med 2020; 9:jcm9041136. [PMID: 32326586 PMCID: PMC7230639 DOI: 10.3390/jcm9041136] [Citation(s) in RCA: 87] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 04/07/2020] [Accepted: 04/12/2020] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence from animal and human studies supports the notion that physical exercise can enhance neuroplasticity and thus reduce the risk of several neurodegenerative diseases (e.g., dementia). However, the underlying neurobiological mechanisms of exercise induced neuroplasticity are still largely unknown. One potential mediator of exercise effects is the neurotrophin BDNF, which enhances neuroplasticity via different pathways (e.g., synaptogenesis, neurogenesis, long-term potentiation). Current research has shown that (i) increased peripheral lactate levels (following high intensity exercise) are associated with increased peripheral BDNF levels, (ii) lactate infusion at rest can increase peripheral and central BDNF levels and (iii) lactate plays a very complex role in the brain’s metabolism. In this review, we summarize the role and relationship of lactate and BDNF in exercise induced neuroplasticity.
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Affiliation(s)
- Patrick Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany; (Y.D.); (N.G.M.)
- Medical Faculty, Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany
- Correspondence:
| | - Yves Duderstadt
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany; (Y.D.); (N.G.M.)
| | - Volkmar Lessmann
- Medical Faculty, Institute of Physiology, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany;
- Center for Behavioral Brain Sciences (CBBS), Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Notger G. Müller
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany; (Y.D.); (N.G.M.)
- Medical Faculty, Department of Neurology, Otto-von-Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany
- Center for Behavioral Brain Sciences (CBBS), Leipziger Str. 44, 39120 Magdeburg, Germany
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