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Cited by 62Foot and Ankle SurgeryLower Extremity Biomechanics and PathologiesTraumatic Brain Injury Research

Brain neuroplasticity related to lateral ankle ligamentous injuries: A systematic review

Maricot, Alexandre, Dick, Emilie, Walravens, Annemiek, Pluym, Bert, Lathouwers, Elke, De Pauw, Kevin, Verschueren, Jo, Roelands, Bart +2 more·2023·Sports Medicine
DOI 10.1007/s40279-023-01834-z
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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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  • When proprioceptive input is impaired, the brain increases FC between the precentral gyrus and MFG.

    “Existing research has also demonstrated that when proprioceptive input is impaired, the brain increases FC between the precentral gyrus and MFG.[37]”

    From Brain Rewires to Stabilize Walking During Visual Impairment · cites this paper as [37]

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    (n.d.) · Chinese Medical Journal / Neuroscience News · doi:10.1097/cm9.0000000000004040

    “…Existing research has also demonstrated that when proprioceptive input is impaired, the brain increases FC between the precentral gyrus and MFG. [37] Furthermore, studies involving interventions on limb motor function through brain–computer interfaces or motor training have identified enhanced…”

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Authors
Maricot, A., Dick, E., Walravens, A., Pluym, B., Lathouwers, E., De Pauw, K., Verschueren, J., Roelands, B., Meeusen, R., & Tassignon, B.
Affiliations
Vrije Universiteit Brussel (BE)
Corresponding author
Tassignon, Bruno
ORCID
Venue
Sports Medicine
Publisher
Springer Science and Business Media LLC
Published
2023-05-08
Volume
53
Issue
7
Pages
1423-1443
ISSN
  • 0112-1642 (ISSN-L)
  • 1179-2035
DOI
10.1007/s40279-023-01834-z
OpenAlex
W4375851244
Cited by
62
References
111
Citations by year
2026: 26 · 2025: 20 · 2024: 13 · 2023: 3
FWCI
3.41
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Sports Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • VUBIR (Vrije Universiteit Brussel) (submittedVersion)
Topics
  • Health Sciences › Medicine › Orthopedics and Sports Medicine › Foot and Ankle Surgery
  • Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
  • Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
Keywords
lateral ankle sprain, chronic ankle instability, neuroplasticity, brain adaptation, sensorimotor network, dorsal anterior cingulate cortex, supplementary motor area, sports injuries, neuroimaging biomarkers, rehabilitation outcomes, fear-avoidance beliefs
MeSH terms
Ankle, Ankle Joint, Brain, Cross-Sectional Studies, Humans, Joint Instability, Sprains and Strains, Ankle Injuries, Disease Progression

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