针刺阳陵泉对中风偏瘫患者感觉运动网络影响的fMRI研究

A functional magnetic resonance imaging(fMRI) study on the effect of acupuncture at GB34(Yanglingquan) on sensorimotor network in stroke patients with hemiplegia

[目的]观察针刺阳陵泉对中风偏瘫患者感觉运动网络的影响特征,探讨针刺阳陵泉穴促进中风偏瘫脑功能重塑的作用机制。[方法]选择符合纳入标准的12例中风偏瘫患者和8名健康受试者,分别进行针刺阳陵泉前后的功能磁共振(fMRI)扫描,采用广义线性模型的方法对提取的感觉运动网络成分进行统计分析,并对比两组激活的脑区特点。[结果]与健康受试者相比,针刺阳陵泉后中风偏瘫患者感觉运动网络成分增强的脑区主要有右扣带回、右额上回、右额内侧回、右舌回、右小脑山坡以及左楔前叶和左顶上小叶,减弱的脑区主要有左前扣带回、左额上回、右额上回、左额中回、左额下回、左额内侧回、右额内侧回、左颞上回、左楔叶、左楔前叶。[结论]针刺阳陵泉穴可通过调节双侧大脑半球感觉运动网络相关脑区活动,增强感觉反馈对运动输出的作用,促进中风偏瘫患者脑功能重塑。

[Objective] To observe the characteristic of brain functional regions of the effect of acupuncture at Yanglingquan（GB34） on sensorimotor network of stroke patients with hemiplegia, and investigate the effect mechanism of acupuncture at Yanglingquan（GB34） on promoting brain reorganization of stroke patients with hemiplegia. [Methods] 12 stroke patients with hemiplegia and 8 healthy controls in accordance with the inclusive criteria were recruited and underwent resting state f MRI scanning before and after acupuncture stimulation,the method of generalized linear models was used to analyze the components of sensorimotor network extracted from all the subjects and compare the brain regions activated by acupuncturing at Yanglingquan（GB34）. [Results] Compared with healthy controls, acupuncture at Yanglingquan（GB34） showed positive effect at right cingulate gyrus, right superior frontal gyrus, right medial frontal gyrus, right lingual gyrus, right declive, left precuneus and left superior parietal lobule, while negative effect mainly occurred at left anterior cingulate gyrus, left superior frontal gyrus, right superior frontal gyrus, left middle frontal gyrus, left inferior frontal gyrus, left medial frontal gyrus,right medial frontal gyrus, left superior temporal gyrus, left cuneus, and left precuneus. [Conclusion] Acupuncture at Yanglingquan（GB34） may promote the brain reorganization of stroke patients with hemiplegia by modulating some brain regions activity related to the sensorimotor network of the bilateral cerebral hemisphere and enhancing the effect of sensory feedback on motion output.