基于局部一致性算法的周围性面瘫针刺治疗静息态功能MRI研究

Cerebral regional homogeneity of peripheral facial paralysis treated by acupuncture: a resting-state fMRI study

目的研究在静息状态下周围性面瘫患者临床针刺治疗不同病程状态下的脑区局部一致性(regional homogeneity,Re Ho)变化特点,探讨针刺治疗周围性面瘫的可能中枢整合机制。材料与方法采用静息态f MRI技术,采集32例健康志愿者及47例面瘫患者临床针刺治疗不同病程状态下(面瘫早期组、后期组及治愈组)的BOLD数据,采用Re Ho的数据后处理方法进行分析,将面瘫早期组、后期组及治愈组分别与健康志愿者Re Ho值比较,获取有统计学意义的差异脑区。结果 (1)面瘫早期组Re Ho增高的脑区有右侧额上回、额中回、额下回,左侧楔前叶、后扣带回和颞上回,Re Ho值减低脑区有右侧颞下回、楔叶和楔前叶;(2)面瘫后期组Re Ho增高的脑区有左侧SII、颞上回、额上回、中央旁小叶、楔叶、楔前叶和右侧额下回;(3)面瘫治愈组Re Ho增高的脑区有左侧中央旁小叶、梭状回和颞上回。结论大脑皮层运动前区(PMA)、辅助运动区(SMA)是周围性面瘫患者脑功能重组及代偿的关键区域,也是针刺治疗周围性面瘫患者重要的调制和关键代偿区域。

Objective： To analyze the changes of regional homogeneity and explore the central mechanisms through the treatment of peripheral facial paralysis with acupuncture in the different pathological stages. Materials and Methods： 32 healthy adult volunteers and 47 patients with peripheral facial paralysis participated in the study. Resting-state fMRI were acquired for each volunteer and patient. The ReHo approach was used to compare the peripheral facial paralysis groups of different pathological stages to healthy group. Results： Compared to healthy group,（1） In the early group, the increased ReHo areas were showed in the right superior frontal gyrus, middle frontal gyrus, inferior frontal gyrus, and the left precuneus, posterior cingulated gyrus, superior temporal gyrus, while the decreased areas were showed in the right inferior temporal gyrus, cuneus and precuneus.（2） In the later group, the increased ReHo were found in the left SII, superior temporal gyrus, superior frontal gyrus, paracentral lobule, cuneus, precuneus, and the right inferior frontal gyrus.（3） In the recovered group, the increased ReHo were found in the left paracentral lobule, fusiform gyrus and superior temporal gyrus. Conclusions： The brain areas of the premotor cortex（PMA）, supplementary motor area（SMA） were likely to be the key areas of compensatory and brain functional reorganization in patients with peripheral facial paralysis. These areas may be the key regions for integration and modulation in the patients suffering from peripheral facial paralysis treated by acupuncture.