Association Between Neural Plasticity and Pain-Related Fear in Chronic Ankle Instability: A Structural Neuroimaging...

Area of Science:

• Neuroscience
• Orthopedics
• Psychology

Background:

• Pain-related movement fear is a key factor in chronic ankle instability (CAI), leading to persistent pain and functional limitations.
• The underlying neural mechanisms driving this fear and its impact on CAI are not well understood.

Purpose of the Study:

• To identify differences in brain regions associated with emotion and pain between individuals with CAI and healthy controls (HC).
• To explore the neural mechanisms of pain and fear in CAI, focusing on associations with pain-related neural plasticity.

Main Methods:

• A cross-sectional study involving 28 participants with CAI and 28 HCs.
• Analysis of T1 structural imaging data to compare gray matter (GM) density in pain-related brain areas.
• Assessment of fear of movement (Tampa Scale of Kinesiophobia - TSK) and pain intensity (visual analog scale - VAS).

Main Results:

• Participants with CAI exhibited significantly lower GM density in the prefrontal cortex (PFC) and periaqueductal gray (PAG) compared to HCs.
• In CAI participants, reduced PFC GM density correlated negatively with TSK scores (fear of movement).
• Reduced PAG GM density correlated negatively with VAS scores (pain intensity) during intense exercise.

Conclusions:

• Atrophy in the PFC and PAG may be linked to pain-related fear in individuals with CAI.
• Psychological factors, such as fear of movement, play a significant role in the functional recovery of CAI.
• Clinical approaches to CAI should integrate the assessment and management of psychological barriers.