Reduction in preparatory brain activity preceding gait initiation in individuals with chronic ankle instability: A...

Evidence suggests that chronic ankle instability (CAI) is not merely a peripheral musculoskeletal injury but should be recognized as a neurophysiological dysfunction. This reflects a paradigm shift from focusing on peripheral structural changes to emphasizing the central nervous system. However, changes in cortical activity during functional activities remain poorly understood. Thus, this study aimed to compare preparatory brain activity during gait initiation (GI) through movement-related cortical potentials (MRCPs) in individuals with CAI and healthy subjects. The proactive components of MRCPs, including contingent negative variation (CNV) and event-related desynchronization (ERD), were measured using electroencephalography. The primary outcomes were late CNV amplitude, CNV peak amplitude, CNV peak time, and alpha/beta ERD. The results indicated that the late CNV amplitude was significantly lower in the CAI group compared to the healthy group at the Fz and Cz electrodes (P < 0.001). The CAI group also demonstrated lower CNV peak amplitude at the Fz, Cz, and Pz electrodes (P < 0.0025). Additionally, in the CAI group, signals peaked earlier at the Cz electrode (P = 0.002). Furthermore, alpha ERD at Pz was significantly lower in the CAI group than in the healthy group (P = 0.003), suggesting diminished preparatory brain activity during GI in CAI subjects. Recognizing CAI as a condition involving both peripheral and central dysfunctions highlights the importance of a multidisciplinary approach in treatment and rehabilitation. This approach should target brain activity in addition to peripheral structures, potentially leading to improved long-term outcomes for patients.