基于局部一致性方法探讨电针针刺单、组穴对健康志愿者默认网络的影响

Regional homogeneity analysis on multi-points acupuncture mobilizing the brain's default mode in healthy subjects

目的 :利用静息态f MRI探讨电针单、组穴对健康志愿者默认网络(DMN)局部一致性(Re Ho)的影响。方法 :募集符合严格入选标准的健康志愿者54例,随机分为3组,每组18例,分别给予双侧百劳穴、百劳+合谷穴(组穴1)、百劳+中渚穴(组穴2)针刺刺激,比较各组针刺前后DMN Re Ho的差异。结果:针刺单穴仅引起双侧额内侧回Re Ho值升高,而针刺组穴1、组穴2除均引起楔前叶、后扣带回Re Ho值的降低,还分别引起左顶下小叶、海马旁回Re Ho值的升高。结论:针刺单、组穴均可引起DMN Re Ho的改变,但组穴所涉及的脑区更广泛、复杂,涉及感觉、自主认知、情感及疼痛处理等多个方面;后扣带回、楔前叶可能是针刺组穴对DMN发挥调节作用的关键区域,针刺组穴可能通过改变该区域神经元活动的同步性,从而发挥疗效。

Objective：To explore the effects of single and multi-points acupuncture in the default network （DMN）in healthy subjects based on regional homogeneity analysis. Methods：54 healthy subjects,who strictly matched selected criteria and age-matched,were randomly divided into 3 groups （18 people each）. The first group were given the acupuncture treatment at bailao （EX-HN15）,the second group at bailao and hegu（EX-HN15 plus SJ3）,and the third group at bailao and zhongzhu （EX-HN15 plus LI4）. Resting state BOLD-fMRI was performed to compare the differences on regional homogeneity of DMN between before and after acupuncture in each group. Results：After single point acupuncture treatment,increased ReHo was only found in both sides of medial frontal cortex. After transcutaneous electrical stimulation on acupuncture EX-HN15 plus LI4 and EX-HN15 plus SJ3,the common regions of ReHo decreased can be found in the posterior cingulate gyrus and the precuneus, while increased ReHo was found in the left inferiorparietal lobule and in the parahippocampal gyrus,respectively. Conclusions： Single point and multi points acupuncture treatments may both affect the ReHo of DMN,but the latter referred wider and more complicated encephalie regions,related to the feeling,independent cognition,emotion and pain management and so on. The ReHo changes of DMN following different multi-points acupunctures treatments not only have some commonality ,but also posses their respective characteristics. The posterior cingulate gyrus and the precuneus might be the pivotal brain region the multi-points treatment affecting and mobilizing the brain＇s DMN,and multi-points treatment exert the therapeutic effect possible through altering the ReHo of these.