针刺阳陵泉对脑梗死患者白质结构的影响

Effect of Acupuncture at Yanglingquan on White Matter Structures of Stroke Patients

目的研究针刺阳陵泉穴后脑卒中患者白质结构的变化。方法 6例脑卒中恢复期左侧偏瘫的患者,以假穴为对照,在针刺左侧阳陵泉前后对患者进行弥散张量成像(DTI)检查,采用西门子1.5T磁共振仪采集数据,应用FSL软件包中的基于传导束的空间统计(TBSS)方法对针刺前后的数据进行比较。结果针刺阳陵泉穴对脑白质各向异性(FA)的影响强于假穴的区域包括左侧中央前、后回,颞中、下回,辅助运动区,额下回,内囊,穹窿和双侧顶下回。这些区域中走行的纤维束有锥体束、弓状束、胼胝体纤维和皮层间联络纤维,涉及运动代偿、体感、语言和记忆等多个功能网络。结论与假穴相比,针刺阳陵泉可使脑梗死患者的白质超微结构出现变化,主要的变化区域出现在健侧半球,与多个脑功能网络相关。

Objective To explore the effect of acupuncture at Yanglingquan（GB 34） on white matter structure of stroke patients. Methods 6 stroke patients with left hemiplegia in recovery stage were recruited. The sham acupoint was as control, the diffusion tensor imaging（DTI） data in a 1.5 T SIEMENS scanner before and after acupuncture at Yanglingquan point was collected. Differences between the two conditions were compared with the Tract-Based Spatial Statistics（TBSS）, which is one of FSL tools. Results The brain areas included left precentral gyrus, postcentral gyrus, middle temporal gyrus, inferior temporal gyrus, supplementary motor area, inferior frontal gyrus, internal capsule, fornix and bilateral inferior parietal gyrus, in which the verum acupuncture had stronger effect on fractional anisotropy（FA） than the sham acupuncture. White matter tract such as pyramidal tract, arcuate fasciculus, corpus callosum and other inter-cortex association fibers passed these brain areas. The fiber tracts and brain areas were found to be involved with multiple brain networks of motor compensation, somatosensory, language and cognition. Conclusion Compared with the sham point, acupuncture at Yanglingquan point can change the microstructure of stroke patients＇ white matter, mainly in the inaffected side and related to multiple functional networks.