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Patients with shoulder instability show differences in cortical activation in shoulder movement
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VIENNA — Patients with shoulder instability have a distinct pathophysiology and demonstrate fundamental differences in cortical activation in shoulder movement, according to a study presented during the Free Papers Award Session for Orthopaedics at the 18th EFORT Annual Congress in Vienna.
Researchers evaluated 16 patients with shoulder instability related to muscle patterns and atraumatic structural issues (Stanmore triangle polar type II/III). Also recruited were 16 age-matched participants to serve as controls. Both groups undertook simple shoulder movements while being assessed by functional MRI and diffusion-weighted MRI. Both groups completed the Oxford Instability Shoulder Score and Western Ontario Shoulder Instability Index questionnaires.
The researchers found that overall, the patient group had higher levels of activation in shoulder movement in both their white matter and grey matter. A distinct area of activation, seen only in the patient group, was identified in the motor cortex of this group. Differences in the neural tracks of the white matter of the patient group vs. the control group were also seen. This disparity was particularly pronounced in the corpus callosum, which is an area of interconnection of the premotor, supplementary motor and motor cortex.
“This study, for the first time, establishes that this patient group fundamentally moves the shoulder differently,” Anthony Howard, PhD, NIHR Clinical Lecturer in Trauma & Orthopaedic Surgery at Leeds Teaching Hospitals NHS Trust, School of Medicine at University of Leeds, told Orthopaedics Today Europe. “This is important, as previously, it was thought that they dislocated on purpose and thus were treated poorly by the surgical community. Further, as we have the ability to change which area of the brain we use for movement, we can develop better ways to treat these patients rather than surgery.” – by Jennifer Byrne
- Reference:
- Howard A, et al. Paper #601. Presented at: 18th EFORT Annual Congress; 31 May - 2 June 2017; Vienna.
- For more information:
- Anthony Howard, PhD, can be reached at Leeds University, Leeds, LS2 9JT, United Kingdom; email: anthonyjhoward@aol.com.
Disclosure: Howard reports no relevant financial disclosures.