Disclosures: Joana Barroso, MD Msc: No financial relationships or conflicts of interest  

Objective: Characterize morphological neocortical brain changes in hip and knee osteoarthritis (OA) patients.

Design: Cross-sectional cohort study of hip (HOA) and knee OA (KOA) patients.

Setting: Outpatient Orthopedic Surgery Clinic.

Participants: 95 KOA, 25 HOA patients with indication for total joint replacement; 36 healthy controls.

Interventions: We collected high-resolution T1-anatomical brain images, demographic information, physical performance tasks and multiple questionnaires covering pain characteristics, anxiety and depression, health and quality of life.

Main Outcome Measures: Global and regional GM density, assessed with voxel-based morphometry (VBM). Analysis was performed using FSL 4.0 software. One-way between subjects’ ANOVA, with age, gender and total ICV as covariates of no interest was performed for a) native brain and b) flipped brain regarding laterality of OA. Group contrast clusters were identified using threshold-free cluster enhancement, at an uncorrected P value < .001.

Results: Neocortical GM changes involved anterior cingulate (ACC), paracingulate gyri and supplementary motor area on native brain analysis (cluster peak (CP) F value =12.8, P<.001). When assessing lateralization of OA (flipped brain analysis), lower GM density was present bilaterally in the ACC, ipsilateral middle frontal gyrus and contra-lateral primary motor cortex (PMC) (CP F values: 18.8-10.3, P<.001). Post-hoc analysis revealed ACC lower density was associated with worse scores in HOOS-Pain, ADL and physical performance tasks. PMC lower volumes in both OA groups were associated with worse physical performance tasks (r2>0.3, P<.001).

Conclusions: Our results show neocortical GM density changes in OA engage multiple motor areas. PMC changes respect functional lateralization and relate to worse physical performance. The cingulate motor areas, related to intentional motor control and movement execution, show lower density for HOA, and associate with worse physical function. We confirm there is a neocortical morphological adjustment in OA that is associated with motor skills and function. Further studies of functional changes in brain networks will provide additional data for cortical motor reorganization in OA.

Level of Evidence: Level II

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/brain-neocortical-volumetric-changes-engage-primary-and-cingulate-motor-areas-in-osteoarthritis-a-voxel-based-morphometry-study/