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Flanagan Dissertation_FINAL.pdf (17.45 MB)

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Neurological Basis of Persistent Functional Deficits after Traumatic Musculoskeletal Injury

Flanagan, Shawn D
http://rave.ohiolink.edu/etdc/view?acc_num=osu1469031876

Abstract Details

2016, Doctor of Philosophy, Ohio State University, Kinesiology.
Traumatic musculoskeletal injury is associated with chronic functional deficits that may result from changes in brain function and structure. The neurological underpinnings of such maladaptive responses are unknown and clarification will likely require the use of multimodal neuroscientific techniques that perturb and measure brain activity with high temporal and spatial resolution. The purpose of this investigation was to produce a neurological map of knee function under resting and active conditions, including the identification of brain circuits affected by traumatic musculoskeletal injury. Twenty-three women (N=23, age 21±3yr, weight 65.8±8.8kg, height 165.2±6.2cm) volunteered to participate in a series of mixed methods experiments. Ten subjects experienced unilateral anterior cruciate ligament (ACL) rupture and reconstruction six months to five years prior to the study (3.1±1.1yr). Thirteen age-, height-, weight-, handedness-, and footedness-matched participants served as controls. The neurological basis of persistent functional deficits was examined on three separate occasions with transcranial magnetic stimulation, tests of physical performance, and functional magnetic resonance imaging. Comparisons of corticospinal, functional, and hemodynamic responses were made between the injured and uninjured leg of subjects with traumatic injury and controls with no history of lower body injury. At rest, leg injury was associated with a reduction in the excitability of the motor cortical circuits governing the injured leg. Injury was also associated with lower maximal force production in the injured leg and a reduction force asymmetry compared to controls. Altered sensorimotor functions included impaired development of fine motor skill and a trend of proprioceptive loss with increased reliance on visual inputs. Imagined use of the injured leg during a task that challenged executive function increased activity in the respective sensorimotor regions to a lesser extent compared with controls. Most notably, activity in the right dorsolateral prefrontal cortex (dlPFC) increased more in injured participates and the magnitude was proportional to the extent of injured leg use. In summary, we observed long-term bilateral impairments in various measures of performance after traumatic musculoskeletal injury. Deficits were associated with alterations in the corticospinal circuits that govern the legs. Moreover, we present evidence to suggest such changes may partially reflect alterations in salience or motivation produced in the prefrontal association cortex. Pharmacological, electromagnetic, or behavioral therapies that favorably modulate such activity represent attractive candidates for the improvement of long-term outcomes and recovery during rehabilitation.
William Kraemer (Advisor)
James Onate (Committee Member)
Jeff Volek (Committee Member)
Carl Maresh (Committee Member)
136 p.
Anatomy and Physiology; Biology; Electromagnetism; Experiments; Health Sciences; Kinesiology; Medical Imaging; Neurobiology; Neurology; Neurosciences; Physical Therapy; Physiology; Psychobiology; Rehabilitation; Scientific Imaging; Sports Medicine
Transcranial Magnetic Stimulation; functional magnetic resonance imaging; musculoskeletal injury; physical performance; neuroplasticity; central nervous system; neurophysiology; neuroscience; anterior cruciate ligament

Recommended Citations

Citations

  • Flanagan, S. D. (2016). Neurological Basis of Persistent Functional Deficits after Traumatic Musculoskeletal Injury [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1469031876

    APA Style (7th edition)

  • Flanagan, Shawn. Neurological Basis of Persistent Functional Deficits after Traumatic Musculoskeletal Injury. 2016. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1469031876.

    MLA Style (8th edition)

  • Flanagan, Shawn. "Neurological Basis of Persistent Functional Deficits after Traumatic Musculoskeletal Injury." Doctoral dissertation, Ohio State University, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=osu1469031876

    Chicago Manual of Style (17th edition)

osu1469031876
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This open access ETD is published by The Ohio State University and OhioLINK.