Brain Function Connectivity May Contribute to ACL Injury Risk

Published February 2019 | Journal of Science and Medicine in Sport

For an athlete, few things can shut down a season faster than an anterior cruciate ligament (ACL) injury. Yet most ACL injuries stem from motor-coordination errors, not contact.

Researchers at Cincinnati Children’s wondered if direct alterations within the central nervous system might predict ACL risk. That is, could poorer brain functional connectivity indicate an inclination toward motor coordination problems and higher injury risk? Their findings received the journal’s Editor’s Choice award.

The study, based on data from 57 female high school athletes, demonstrated that those who completed a season without ACL injury exhibited stronger functional connections between a cortical sensory-motor region and a cerebellar region responsible for balance and coordination. The findings suggest that depressed connectivity between the primary somatosensory cortex and cerebellum indicates a possible neural motor dysfunction underlying ACL injury risk.

Jed Diekfuss, PhD, lead author, said their research also has identified similar brain predispositions among male athletes who experience ACL rupture, but that more research with larger sample sizes are needed.

“Clinicians, coaches, and researchers should consider brain-based approaches in addition to standard, movement-based training to strengthen functional connectivity,” Diekfuss says.

Integrating real-time biofeedback technologies, key motor learning principles, or stroboscopic training into standard ACL injury prevention programs may promote adaptive neuroplasticity.

“This research represents a significant transformation of our understanding of mind-body interactions,” says Greg Myer, PhD, senior author. “Innovative movement-based fMRI methods could initiate a paradigm shift for discovering the actual neural drivers of movement, pain, and disrupted neuromuscular control.”