2022 Fiscal Year Final Research Report

Investigation of pathophysiology of recurrent anterior shoulder dislocation by comprehensive evaluation for increasing the rate of return to sports

Research Project

PDF

Project/Area Number	19K09542
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 56020:Orthopedics-related
Research Institution	Gunma University
Principal Investigator	SHITARA HITOSHI 群馬大学, 医学部附属病院, 講師 (20588652)
Co-Investigator(Kenkyū-buntansha)	佐々木毅志群馬大学, 医学部附属病院, 助教 (50834446) 濱野哲敬群馬大学, 医学部附属病院, 医員 (60813201) 一ノ瀬剛群馬大学, 大学院医学系研究科, 研究員 (70742550)
Project Period (FY)	2019-04-01 – 2023-03-31
Keywords	fMRI / Proprioception / Motor control / 肩 / 脱臼
Outline of Final Research Achievements	In recurrent anterior shoulder instability (RSI), proprioception is known to be impaired. However, there have been no studies that have evaluated the proprioceptive deficits by brain activity. In this study, we evaluated brain activity using functional MRI (fMRI) during voluntary and passive shoulder movements in healthy subjects and patients with RSI to clarify the brain activity related to proprioceptive sensation and the correlation between brain activity and severity of RSI. Patients with RSI showed significantly lower proprioception-related brain activity than healthy subjects, and proprioception-related brain activity in the right cerebellum showed a significant negative correlation with RSI severity.The study revealed part of the pathophysiology of RSI, in which not only the shoulder is repeatedly dislocated, but also central changes occur.
Free Research Field	整形外科
Academic Significance and Societal Importance of the Research Achievements	怪我により繰り返し肩が脱臼する反復性肩関節前方脱臼の原因は、単なる関節の骨や靭帯などの肩関節内の損傷によると考えられてきた。しかし、運動の命令を出す脳機能も非常に重要であるが、運動の司令塔の脳がどのように変化しているか、知られていなかった。反復性肩関節前方脱臼の患者では、肩を動かした際に起こる位置情報（固有受容覚）の活動が患者群では著しく低下し、脳は正しい運動の命令を出そうと過剰に活動を起こしていた。この過剰な脳活動は、異常な運動の命令を引き起こし、繰り返す脱臼を悪化させる原因になりうるという病態生理の一部が明らかになり、非常に学術的・社会的意義のある研究成果となった。