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Brain activity in the right-frontal pole and lateral occipital cortex predicts successful post-operatory outcome after surgery for anterior glenoumeral instability
Univ Basel, Dept Psychiat UPK, Basel, Switzerland..
Univ Hosp Geneva, Div Orthopaed & Trauma Surg, Dept Surg, Geneva, Switzerland..
Univ Hosp Geneva, Div Orthopaed & Trauma Surg, Dept Surg, Geneva, Switzerland.;Univ Geneva, Fac Med, Geneva, Switzerland.;La Tour Hosp, Div Orthopaed & Trauma Surg, Geneva, Switzerland..
Univ Hosp Geneva, Div Orthopaed & Trauma Surg, Dept Surg, Geneva, Switzerland..
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2017 (English)In: Scientific Reports, ISSN 2045-2322, E-ISSN 2045-2322, Vol. 7, 498Article in journal (Refereed) Published
Abstract [en]

Shoulder apprehension is more complex than a pure mechanical problem of the shoulder, creating a scar at the brain level that prevents the performance of specific movements. Surgery corrects for shoulder instability at the physical level, but a re-dislocation within the first year is rather common. Predicting which patient will be likely to have re-dislocation is therefore crucial. We hypothesized that the assessment of neural activity at baseline and follow-up is the key factor to predict the postoperatory outcome. 13 patients with shoulder apprehension (30.03 +/- 7.64 years) underwent clinical and fMRI examination before and one year after surgery for shoulder dislocation contrasting apprehension cue videos and control videos. Data analyses included task-related general linear model (GLM) and correlations imaging results with clinical scores. Clinical examination showed decreased pain and increased shoulder functions for post-op vs. pre-op. Coherently, GLM results show decreased activation of the left pre-motor cortex for post-surgery vs. pre-surgery. Right-frontal pole and right-occipital cortex activity predicts good recovery of shoulder function measured by STT. Our findings demonstrate that beside physical changes, changes at the brain level also occur one year after surgery. In particular, decreased activity in pre-motor and orbito-frontal cortex is key factor for a successful post-operatory outcome.

Place, publisher, year, edition, pages
NATURE PUBLISHING GROUP , 2017. Vol. 7, 498
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Radiology, Nuclear Medicine and Medical Imaging
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URN: urn:nbn:se:uu:diva-320037DOI: 10.1038/s41598-017-00518-9ISI: 000397729900004PubMedID: 28356560OAI: oai:DiVA.org:uu-320037DiVA: diva2:1088573
Available from: 2017-04-13 Created: 2017-04-13 Last updated: 2017-04-13Bibliographically approved

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