电针正常人足三里和关元穴中枢效应的fMRI脑功能成像比较

Comparison of Brain Effects of Electroacupuncture at Zusanli(ST 36) and Guanyuan(CV 4) Shown by fMRI in 21 Healthy Volunteers

目的:利用fMRI脑功能成像,比较电针时位于肢体的足三里穴及腹部的关元穴激活的脑功能区及其功能区网络连接的异同。方法:21名健康志愿者参加电针足三里穴、关元穴时的fMRI试验。分别在针刺前静息状态、留针、电针(15Hz,3次30s,间隔1min)、拔针后静息态采集fMRI脑功能数据,并记录电针任务时针感。采用t检验及卡方检验分析针感,SPM 2、短程和长程"中心度"法分析脑激活功能区及其之间的功能网络连接。结果:在电针电流无显著性差异条件下,电针足三里穴较关元穴诱导出了更强的胀满感及麻木感。电针两穴均产生了相似的前下扣带回-额叶内侧回网络的显著负激活效应,留针及电针能改变脑静息态脑功能默认功能模式,于额叶内侧回、扣带前回前下部短程脑功能网络出现了明显的即时针刺后效应。足三里穴较关元穴产生了更强的短程脑功能网络连接。结论:针刺足三里、关元穴具有显著相似的对脑边缘叶-额叶内侧皮层脑网络的调制作用,但也存在小的差异,体现穴位脑效应的相对特异性。

Objective To observe different brain effects of electroacupuncture（EA） stimulation of Guanyuan（CV 4） and Zusanli（ST 36） in the normal subjects by using functional magnetic resonance image（fMRI）.Methods Twenty-one healthy volu-nteers were recruited in the present study.fMRI was used to investigate brain responses [blood-oxygenation-level-dependent（BOLD） signals] to EA stimulation of CV 4 and ST 36.A filiform silver needle was inserted into CV 4 or the left ST 36 randomly in two consecutive fMRI tests,and then manipulated with uniform reducing-reinforcing methods to induce ＂Deqi＂.fMRI scan was performed before needling,during needle retention,during EA stimulation,and post-EA.Volunteer＇s subjective needling sensations were recorded after EA.Data of fMRI were analyzed by using software SPM 2 and fMRI was mapped by Degree Centrality Mea-sure method for whole brain correlation.The activation,deactivation,short-distance and long-distance functional connectivity maps of cerebral regions were investigated.Results The fullness and numbness feelings of the subjects were stronger during EA at ST 36 than at CV 4.EA at ST 36 or CV 4 induced apparent similar deactivation effects in the anterior cingulate and medial prefrontal cortices.The default mode of the brain at rest state was modified by needle retention and EA stimulation,respectively.The functional brain network was significantly changed after EA.The instant post-acupuncture effects（enhancement of the shortdistance functional connectivity） were mainly found in the ventral medial prefrontal cortex（VMPF） and ventral anterior cingulate cortex（vACC） in the limbic-paralimbic-neocortical network,and there were a little bit stronger signals in ST 36 than in CV 4.Conclusion EA stimulation of CV 4 and ST 36 induces a similar modulation effect in the limbic-medial prefrontal network in healthy subjects.