Proprioception Deficits in Chronic Ankle Instability is Associated with the Structural and Functional Alternations in Cerebellar Vermis: A Multimethod MRI study

Research Objectives: To investigate whether the structural and functional features of the cerebellar vermis (i) differed between patients with chronic ankle instability (CAI) and healthy controls, and (ii) were associated with the proprioception deficits in patients.

Design: Cross-sectional study.

Setting: General community.

Participants: Convenience samples, including 24 patients with unilateral CAI and 26 healthy controls, were enrolled for inclusion from the local community.

Interventions: Not applicable.

Main Outcome Measures: All participants underwent structural and resting-state functional magnetic resonance imaging scanning to calculate the voxel-based morphometry (VBM) and fractional amplitude of low-frequency-fluctuation (fALFF) of vermis. Between-group comparisons within the ankle instability-related subregions of the vermis were performed, and the correlation analyses would be performed between outcomes of the surviving subregions and the proprioceptive scores of Ankle Inversion Discrimination Apparatus for Landing (AIDAL) test.

Results: The subregion of Vermis IV/V survived the multiple comparisons correction to reveal the lower VBM value in patients than the healthy controls (Cohen’s d = -0.968, 95% Cls -1.575 to -0.361), and the patients also shown significantly higher fALFF (Cohen’s d = 0.666, 95% Cls 0.172 to 1.161) in this subregion. After controlling the demographic features, the proprioceptive scores were significantly correlated with the VBM values (r = 0.622, p = 0.002), and the fALFF values (r =-0.512, p = 0.015) in patients group.

Conclusions: Patients with CAI have lower grey matter volume and higher intensity of intrinsic activity in the cerebellar vermis IV/V subregion than in that of healthy controls. The more serious proprioception deficits was significantly associated with the decreased volume and the increased intrinsic activity of vermis in patients, which indicates that the structural degeneration and functional compensation in cerebellar vermis might be a part of pathological process in the proprioception deficits of CAI.

Author(s) Disclosures: None.