The Enlarged Cerebellar Vermis Gray Matter Volume In The Aclr Population Withself-reported Knee Function: A Cross-sectional Study

PURPOSE:Anterior cruciate ligament(ACL) injuries might lead to maladaptive neuroplasticity especially in the cerebellum. Our hypothesis is that the gray matter volume (GMV) in the cerebellar vermis is reduced in anterior cruciate ligament reconstruction(ACLR) patients and is positively correlated with balance deficits. METHODS:A group of 22 ACLR participants with and 20 healthy controls underwent GMV imaging scanning, with the cerebellar vermis as the regions of interest. Correlation analyses were performed to examine the potential relationship between the GMV and both the Y-balance test(YBT) scores and the Lysholm scale score of ACLR. RESULTS:Compared with the control group, ACLR reported significantly lower knee function (Lysholm) (P < 0.01). For GM outcomes, ACLR showed significantly higher values than healthy controls with vermis X with a large effect size (Cohen’s d = 0.86; 95% CI, 0.23 to 1.49; P-corrected = 0.04). Based on correlation analysis, the Lysholm scale score was positively correlated with vermis x volume(r = 0.157, P = 0.034). CONCLUSIONS:This study revealed ACLR exhibited an increased GM value of an ROI within the cerebellar vermis compared with noninjured participants, and the degree of enlarged volume was positively associated with knee function. Table 1. - The demographic and clinical features of all participants. ACLR(n=22) CONTROL(n=20) P value Sex(female/male) 5/17 4/16 / Age(years,mean±SD) 36.6±7.14 33.57±8.68 n.s Height(cm) 172.36±5.82 172.55±7.76 n.s Weight(Kg) 71.75±11.77 72.98±11.11 n.s Tegner(median[IQR]) 4.00[3.00,6.00] 4.00[3.00,8.80] 0.09 Lysholm(median[IQR]) 91.50[61.20,100.00] 100.00[90.00,100.00] <0.01** YBT-A(mean±SD) 0.61±0.09 0.66±0.07 0.02* YBT-PM(mean±SD) 1.1±0.1 1.06±0.1 0.08 YBT-PL(mean±SD) 1.11±0.09 1.06±0.09 0.05 Table 2. - The GM outcomes between ACLR and healthy controls of different regions in vermis. Regions of Interest ACLR(n=22) CONTROL(n=20) P Value P Valune (Corrected) Cohen’s d Effect Size (95% CIs) Vermis_I_II 0.19±0.04 0.18±0.04 0.28 1 0.14(-0.26 to 0.74) Vermis_III 0.33±0.05 0.32±0.05 0.36 1 0.11(-0.49 to 0.71) Vermis_IV_V 0.38±0.04 0.37±0.05 0.27 1 0.17(-0.43 to 0.77) Vermis_VI 0.4±0.05 0.41±0.05 0.25 1 -0.20(-0.80 to 0.40) Vermis_VII 0.4±0.04 0.4±0.05 0.5 1 0.02(-0.58 to 0.61) Vermis_VIII 0.48±0.06 0.46±0.06 0.18 1 0.25(-0.36 to 0.85) Vermis_IX 0.53±0.08 0.51±0.07 0.16 1 0.25(-0.36 to 0.85) Vermis X 0.2±0.03 0.18±0.02 0.0051** 0.04 0.86(0.23 to 1.49)