The relationship between structural changes in the cerebral gray matter and diminished balance control performance in patients with chronic ankle instability (CAI) has remained unclear. This paper aimed to assess the difference in gray matter volume (GMV) between participants with CAI and healthy controls (HC) and to characterize the role of GMV in the relationship between disease duration and balance performance in CAI. 42 participants with CAI and 33 HC completed the structural brain MRI scans, one‐legged standing test, and Y‐balance test. Regional GMV was measured by applying voxel‐based morphometry methods. The result showed that, compared with HC, participants with CAI exhibited lower GMV in multiple brain regions (familywise error [FWE] corrected p < 0.021). Within CAI only, but not in HC, lower GMV in the thalamus (β = −0.53, p = 0.003) and hippocampus (β = −0.57, p = 0.001) was associated with faster sway velocity of the center of pressure (CoP) in eyes closed condition (i.e., worse balance control performance). The GMV in the thalamus (percentage mediated [PM] = 32.02%; indirect effect β = 0.119, 95% CI = 0.003 to 0.282) and hippocampus (PM = 33.71%; indirect effect β = 0.122, 95% CI = 0.005 to 0.278) significantly mediated the association between the disease duration and balance performance. These findings suggest that the structural characteristics of the supraspinal elements is critical to the maintenance of balance control performance in individuals suffering from CAI, which deserve careful consideration in the management and rehabilitation programs in this population.

中文翻译：

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灰质体积介导慢性踝关节不稳定的疾病持续时间和平衡控制性能之间的关系


慢性踝关节不稳定（CAI）患者大脑灰质结构变化与平衡控制能力下降之间的关系仍不清楚。本文旨在评估 CAI 参与者和健康对照 (HC) 之间灰质体积 (GMV) 的差异，并描述 GMV 在 CAI 疾病持续时间和平衡能力之间关系中的作用。 42 名 CAI 参与者和 33 名 HC 参与者完成了结构性脑 MRI 扫描、单腿站立测试和 Y 平衡测试。区域 GMV 通过应用基于体素的形态测量方法来测量。结果显示，与 HC 相比，CAI 参与者在多个大脑区域表现出较低的 GMV（家庭误差 [FWE] 校正 p < 0.021）。仅在 CAI 中，但在 HC 中则不然，丘脑 (β = -0.53，p = 0.003) 和海马 (β = -0.57，p = 0.001) 中较低的 GMV 与压力中心 (CoP) 更快的摇摆速度相关。闭眼状态下（即平衡控制性能较差）。丘脑（介导百分比 [PM] = 32.02%；间接效应 β = 0.119，95% CI = 0.003 至 0.282）和海马（PM = 33.71%；间接效应 β = 0.122，95% CI = 0.005 至 0.278）的 GMV ）显着调节疾病持续时间和平衡能力之间的关联。这些发现表明，脊柱上元件的结构特征对于 CAI 患者维持平衡控制能力至关重要，在该人群的管理和康复计划中值得仔细考虑。