Functional brain changes, including increased connectivity in sensorimotor and emotional regulation areas, were linked to clinical outcomes in recurrent shoulder instability.
Are there structural and functional brain changes associated with recurrent shoulder instability compared to healthy controls?
Recurrent shoulder instability is associated with functional brain alterations, particularly increased connectivity in sensorimotor and emotional regulation networks, rather than structural changes.
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OBJECTIVE: To explore (i) structural and functional brain changes associated with recurrent shoulder instability, and (ii) their associations with clinical outcomes. DESIGN: Systematic review of observational and case-control studies. LITERATURE SEARCH: A comprehensive search was conducted in PubMed, Web of Science, and Embase for articles published up to December 2023. Reporting was guided by the PERSiST and PRISMA 2020 guidelines. STUDY SELECTION CRITERIA: Peer-reviewed observational and case-control studies were eligible if they included individuals with recurrent shoulder instability and assessed structural or functional brain changes using neuroimaging. DATA SYNTHESIS: The internal validity of included studies was evaluated using the NIH Quality Assessment Tool for Observational and Cross-Sectional Studies and the Tool for Case-Control Studies. Outcomes were synthesized qualitatively due to heterogeneity in imaging protocols and outcome measures. RESULTS: Seven studies met the inclusion criteria, involving 100 patients with recurrent shoulder instability and 70 healthy controls. Structural brain differences assessed via voxel-based morphometry (VBM) were not significant in three studies, and were significant in one. Six studies reported consistent patterns of neuroplasticity in functional brain outcomes, with increased functional connectivity in the primary sensorimotor cortex, dorsolateral prefrontal cortex, and anterior insula. Four studies identified significant correlations between brain connectivity measures and clinical scores, suggesting a link between sensorimotor and emotional regulation networks and functional outcomes in recurrent shoulder instability. CONCLUSION: Functional, rather than structural, brain alterations appeared to be involved in recurrent shoulder instability. These findings support the relevance of central mechanisms in recurrent shoulder instability and require confirmation through longitudinal designs and larger cohorts.
Tooth et al. (Fri,) reported a other. Functional brain changes, including increased connectivity in sensorimotor and emotional regulation areas, were linked to clinical outcomes in recurrent shoulder instability.