VBM-DARTEL法对青少年肥胖针灸治疗的中枢机制研究

Neural mechanism study of acupuncture therapy for obese adolescence with VBM-DARTEL approach

目的应用VBM-DARTEL分析法探讨针灸疗法对肥胖青少年大脑皮层重建的影响。方法 10名单纯性肥胖青少年〔男7例,女3例,14～18岁,右利手,体重指数:(29.03±4.81)kg/m2〕行阶段性针灸减肥治疗,在治疗前、后分别行颅脑高分辨三维T1加权成像,同时招募10名年龄性别相匹配的健康自愿者〔右利手,体重指数:(25.05±5.02)kg/m2〕作为对照组。数据分析使用软件平台为SPM8MATLAB R2009a。结果①右侧额上回,小脑后叶椎体灰质体积减小,右侧中央前回灰质体积增大;左侧海马旁区梭状回,桥脑及中央前回区白质体积减小;右侧楔前叶白质体积增大(P<0.05);②治疗前肥胖受试者与体重正常对照组比较,小脑及外侧苍白球灰质体积增大,桥脑及小脑白质体积减小;治疗后肥胖受试者与体重正常对照组比较,外侧苍白球灰质体积增大更显著,桥脑白质增大,原先位于小脑的灰质及白质差异区未显现。结论①针灸疗法对大脑发育及皮层重建可能存在影响;②正常体重者与肥胖者间可能存在大脑细微结构的差异。

Objective To investigate structural reorganization in the obese children＇s brain with acupuncture therapy via voxel-based morphometry with diffeomorphic anatomic registration through exponentiated lie algebra algorithm （DART- EL） approach. Methods 10 subjects with simple obesity （M：7, F：3, Aged 14-18, right handed, BMI （29.03±4.81） kg/rnz] underwent periodical acupuncture therapy and were taken high resolution TI W MR images of the brain before and after the therapy respectively. Another 10 gender- and age-matched volunteers with normal BMI [right handed, BMI （25.05±5.02） kg/m2） were enrolled as control group. The analysis was carried out using SPM8 software on MATLAB 7.8.0. 347 platform. Results ① VBM-DARTEL study revealed that partial gray matter decrease was found in cortices of right gyri frontalis superior and pyramis of cerebellum posterior lobe and that volume increase in gyri centralis anterior between subjects before and after acupuncture therapy. There were also differences found in white matter. Left Fusiform in Parahippocampa Gyrus, Pontine and Precentral Gyrus were found decrease in volume of white matter. Volume of whitematter in Right Precuneus turned out to be increased. The significant level was 0.05 ; ② Obese Subjects compared to control group showed volume increase in GM of cerebellum and lateral globus pallidus and volume decrease in WM of pontine and cerebellum. After the therapy, Obese Subjects compared to control group showed even larger GM increase in lateral globus palidus and larger pontine WM increase. Previous differences in Cerebellum in both GM and WM were not shown. Conclusion ③ Acupuncture might influence the process of brain development, leading to reorganization of cortices; ④Microstructural difference might exit in brain because of obesity.