人脑对针刺与对指反应的实时动态功能MRI的对比研究

Comparison study of human brain response to acupuncture stimulation vs finger tapping task by using real time fMRI

目的 利用血氧水平依赖 (bloodoxygenleveldepended ,BOLD)实时动态功能磁共振成像技术观察针刺人体足三里和阳陵泉穴对脑运动功能区的影响 ,并对针刺机理进行初步探讨。方法17例健康志愿者 ,行实时动态功能磁共振成像。每人分别接受以下 2项任务 :(1)右手对指运动 ;(2 )被针刺右侧足三里和阳陵泉。检测感兴趣区的相关系数 ,感兴趣区包括两侧的躯体感觉运动区(SMC)、运动前区 (PMC)和副运动区 (SMA)。对被激活的感兴趣区进行计数。采用SAS软件包作精确概率法检验对两组资料进行分析。结果 对指任务除去 1例合作不好 ,其余 16例激活右侧 (SMCR)8例 ,PMCR8例 ,SMA 9例 ,左侧 (SMCL) 16例 ,PMCL9例。针刺任务 3例运动伪影明显没有获得满意图像 ,另有 2例脑功能区无明显激活 ,其余 12例次激活SMCR6例 ,PMCR10例 ,SMA 8例 ,SMCL11例 ,PMCL10例。精确概率法检验Fisher′sexacttest (2 Tail)P >0 .0 5 ,说明 2种刺激兴奋感兴趣区的差异无显著性意义。结论 脑功能磁共振成像在针刺机制和应用价值研究领域具有重要作用 ;但其实用价值尚需结合临床针刺效果进行综合评价和进一步探讨。

Objective To characterize the central nervous system reaction on acupuncture stimulations of ZUSANLI(S36) and YANGLINGQUAN(G34) by using real time imaging processing (RTIP) functional magnetic resonance imaging Methods Functional MR imaging was performed in 17 healthy volunteers with 2 paradigms: acupuncture at acupoints of ZUSANLI(S36) and YANGLINGQUAN(G34) (on the right side) and control stimulations (right finger tapping) Correlation coefficient (CC) of ROI was detected including bilateral sensorimotor area (SMC), premotor cortex (PMC), and supplementary motor area (SMA) Only the ROI in which CC≥0 6 and range exceeded 4 pixels was counted as an activated area Fisher′s exact test was performed to analyze the data in SAS software package Results In tapping finger task, 16 subjects obtained functional MR images satisfactorily except 1 subjects, and 8 of SMC R, 8 of PMC R, 9 of SMA, 16 of SMC L, and 9 of PMC L were activated In acupuncture task, 3 subjects were eliminated for gross motion artifacts, there were 6 of SMC R, 10 of PMC R,8 of SMA,11 of SMC L, and 10 of PMC L were activated in the rest 14 subjects Fisher′s exact test (2 Tail) ( P >0 05) showed that there was no significant difference in ROI activated by two kinds of stimulus Conclusion Real time fMRI was very useful in exploring acupuncture mechanisms However, its value in practice still requires further study and synthetic appraise integrating clinical acupuncture effect