足三里等下肢穴位刺激引发脑运动皮质去激活效应的fMRI研究

Using fMRI to Explore Deactivation in Motor Cortices after Zusanli,Yinlingquan, Fenglong,Sanyinjiao Acupoint Stimulation

目的:观察刺激右侧足三里、阴陵泉、丰隆、三阴交穴区对人体左侧初级运动皮质,运动前区和辅助运动区的去激活效应。方法:共10例受试者接受功能性磁共振成像。采用3.0 T Siemens MAGNETOM Trio磁共振成像系统采集全脑T2*像。穴位刺激采用组块方式。以SPM5软件包分析数据,采用贝叶斯推断方法,识别相对于基线水平,穴位刺激引发的去激活效应信号。结果:无论刺激哪一穴位,在所有受试者中,均可观察到左侧初级运动皮质、运动前区及辅助运动区出现的去激活信号。刺激足三里穴可在8例受试者的左侧初级运动皮质发现激活体素,在9例中可在左侧运动前区及辅助运动区发现激活体素;刺激阴陵泉穴可在所有受试者的左侧初级运动皮质、以及运动前区及辅助运动区发现激活体素;刺激丰隆穴可在9例受试者的左侧初级运动皮质发现激活体素,9例左侧运动前区及辅助运动区发现激活体素;刺激三阴交穴可在9例受试者的左侧初级运动皮质发现激活体素,以及所有受试者左侧运动前区及辅助运动区发现激活体素。结论:刺激足三里、阴陵泉、丰隆、三阴交穴区可在多数受试者中激活初级运动皮质、PMA及SMA脑区,去激活效应的出现则更为广泛。这一现象提示,穴位刺激对中枢的功能调节既包括激活效应,也包括去激活效应。去激活效应在穴位刺激引发的脑功能网络状态变化过程中,发挥何种作用,值得深入研究。

Objectives ： To investigate the deactivation responses of individual areas in the human left primary motor cortices, premotor areas and supplementary motor areas to stimulating acupoints Zusanli, Yinlingquan, Fenglong, Sanyin- jiao of right body - side. Methods ： Ten male healthy subjects received functional MRI examination in a 3T Siemens MAGNETOM Trio system with a block - designed method. BOLD weighted functional images were acquired in the axial plane. Data were analyzed with SPM5 software package to acquire magnitudes of BOLD signal changes with 1 st level Bayesian inference. Results： Deactivated signals were found in left primary motor cortices, premotor areas and supplementary motor areas when stimulating each acupoint for every subjets. For Zusanli stimulation, activated signals were found within left primary motor cortices from eight people out of the ten subjects, and within left premotor areas and supplementary motor areas from nine people out of the ten subjects. For Yinlingquan stimulation, activated signals were found within left primary motor cortices and within left premotor areas and supplementary motor areas from all ten subjects. For Fenglong stimulation, activated signals were found within left primary motor cortices from nine people out of the ten subjects, and within left premotor areas and supplementary motor areas from nine people out of the ten subjects. For Sanyinjiao stimulation, activated signals were found within left primary motor cortices from nine people out of the ten subjects, and within left prcmotor areas and supplementary motor areas from all ten subjects. Conclusion： Zusanli, Yinlingquan, Fenglong or Sanyinjiao stimulation can activate contralateral primary motor cortices, premotor areas and supplementary motor areas formost subjects. However, deactivation can be seen in every condition from each subject. This phenomenon suggests that the effects of acupoint stimulation on central nervous system involve not only activation but deactivation as well. Further studies are needed to explore which role deactivation may play in the process of status changing of brain functional network induced through stimulating such acupoints.