针刺太冲穴的脑功能MRI研究

Study of acupuncture point Liv 3 with functional MRI

目的采用功能MRI(fMRI)方法研究与针刺太冲穴(Liv3)有关的脑功能区,以及可能的针刺后效应。方法健康右利手志愿者18例参加本次实验。实验采用单组块设计,包括静息期、刺激期和针刺后效应期。每名被试只接受1种针刺,即针刺右侧Liv3或针刺相邻假穴位,其中,10例被试者参加穴位针刺,其余8例参加假穴位针刺,同时进行全脑的fMRI。采用统计参数图(SPM99)进行统计学分析,用t检验分析获得刺激期、后效应期状态分别与静息期状态信号对比的脑功能图像,以P<0.001的像素构成统计参数图,最后利用SPM的掩盖(Mask)功能,从针刺激活区中排除假穴位针刺的干扰激活区,得出针刺激活的特异性脑区图。结果排除8例假穴位针刺期激活脑区后,与静息状态比较,针刺10例被试右侧太冲穴激活的脑区主要包括左右小脑(t值分别为10.06、9.82)、前额叶、顶上小叶(t值分别为4.36、4.53)和顶下小叶(t值分别为3.94、4.95)、枕叶、海马旁回(t值分别为5.63、6.32)、岛叶(t值分别为3.82、5.51)、丘脑、豆状核(t值分别为3.24、4.40)以及对侧颞极和前、后扣带回(P值均<0.01)。排除8例假穴位针刺“后效应期”激活区后,针刺10例被试太冲穴后效应期激活的脑区主要包括双侧小脑、前额叶、顶上小叶和顶下小叶、枕叶、豆状核、海马旁回,同侧颞极、海马、岛叶和丘脑,对侧尾状核头和胼胝体以及前、后扣带回。结论针刺Liv3激活视区、边缘系统和皮层下灰质结构,可能是脑内调整的特异性脑区,而且这些区域在后效应期仍有激活,为针刺后效应的存在提供了一定的客观证据,这将为以后针刺实验的科学设计奠定基础工作。

Objective To investigate the mechanism of acupuncture point Liv3 （Taichong） and possible post-effect of acupuncture by using functional magnetic resonance imaging （fMRI） . Methods Eighteen healthy right-handed volunteers participated in the experiment. The experiment used single block design, including rest state, stimulation state and post effect state （PE）. Everyone only received acupuncture at one of the two stimulations, that was ： true acupuncture （TA） at right Liv3 or sham acupoint （SA） near Liv3, in which 10 subjects participated in TA and other 8 subjects in SA. The fMRI data were obtained from scanning the whole brain and were analyzed using SPM99. Significant changes of stimulation state or post effect state compared to rest state were accessed using t-statistics. The t-ratios were used to form the statistical parametric maps which showed brain activation areas by acupuncture above P 〈 0. 001. In order to remove the effects of other non-acupuncture factors, we used the mask function to exclude the areas activated by SA from the areas activated by TA. Results The brain activation areas during TA for 10 subjects exclusive by SA for 8 subjects were showed on bilateral cerebella（t value is 10.06 and 9.82, respectively）, prefrontal lobe （ PF）, superior parietal lobule （ SPL, t value is 4.36 and 4.53, respectively） and inferior parietal lobule （IPL,t value is 3.94 and 4.95 ,respectively）, occipital lobe, parahippocampal gyrus, insula（t value is 3.82 and 5.51, respectively）, thalamus, lentiform nucleus （ t value is 3.24 and 4.40, respectively）, contralateral temporal pole, anterior cingulate cortex （ ACC）, and posterior cingulate cortex （PCC, all of P 〈 0.01 ）. The PE of TA for 10 subjects exclusive by ＂ PE＂ of SA for 8 subjects activated bilateral cerebella, PF, SPL, IPL, occipital lobe, lentiform nucleus, parahippocampal gyrus, ipsilateral tempoaral pole, hippocampus, insula, thalamus, contralateral head of nucleus caudate, corpus callosum, ACC, and PCC. Conclusion Acupuncture at Liv3 activated visual area, limbic system and subcortical gray structures, which were considered as the specific response to Liv3 modulating within the human brain. Moreover, the activation still existed during PE. It provides an objective evidence for PE exiting, which may lay the foundations for later scientific design in acupuncture experiments.