Evidence of Neuroplasticity and Neuroimaging Techniques following Anterior Cruciate Ligament Injury

Abstract

PURPOSE: Recent evidence has linked neural changes in the brain, known as neuroplasticity, to anterior cruciate injury, possibly explaining why some patients suffer repetitive functional instability. Therefore, the purpose of this article was to review the manifestation of central nervous system reorganization following anterior cruciate ligament injury and establish further the application of neuroimaging assessment tools in the evaluation of neuroplasticity after ligamentous injury.METHODS: Previous research articles emphasizing neuromuscular deficits, functional joint instability, and anterior cruciate ligament injury and neuroimaging techniques searched from PubMed databases were reviewed. Additionally, more relevant research articles through a cited reference search from the original research articles were reviewed.RESULTS: Diminished neuromuscular control such as proprioception, muscle activation, and joint stiffness regulation appears to be indirect evidence of neural adaptations that may lead to persistent functional joint instability and future pathological complications.Results of direct measurement of the brain’s function using a variety of neuroimaging tools supports altered cortical activation in the brain corresponding to diminished knee function.CONCLUSIONS: Knee functional deficits after an anterior cruciate ligament injury may be associated with neural adaptations in the brain. Neuroimaging techniques that allow for examination of neural activity in the central nervous system help to better understand the neurophysiological mechanisms underlying the link between the brain’s function and functional joint instability, to develop more effective rehabilitation programs, and to improve patient outcomes.