电针心经穴与非经非穴对rs-fMRI脑功能连接的影响

Effect of Electroacupuncture Stimulation of Acupoints of Heart Meridian on Brain Connectivity in 27 Healthy Volunteer Subjects

目的:观察电针心经穴与同节段非经非穴时脑功能连接的不同变化,为临床运用电针心经穴治疗相关疾病提供影像学依据。方法:将符合纳入标准的健康受试者随机分为电针心经穴组10例和电针非经非穴组10例,电针心经穴组电针右侧下极泉、少海、灵道、神门穴,电针非经非穴组电针右侧同节段非经非穴,以双侧后扣带回为种子点,采用静息态动能磁共振成像,分析两组不同状态脑功能连接的差异。结果:两组电针前静息状态下的脑功能连接未发现存在明显差异的脑区。电针心经穴与非经非穴时两组脑功能连接中相同的脑区为双侧中央后回、右顶下小叶、右额下回;电针心经穴组功能连接中特异性增强的脑区为左侧颞下回、右侧海马旁回,特异性新激活的脑区为左侧中央前回、右侧顶叶楔前叶、左侧顶叶角回、左侧枕下回、左侧脑岛(P<0.05);电针非经非穴组功能连接特异性新激活脑区为左颞上回(P<0.05)。结论:大脑在无任务的安静、清醒状态下存在一定的功能活动。两组脑功能连接中相同的脑区主要与初级感觉区及精细感觉控制区密切相关,提示电针刺激均可引起一般体感觉区和精细感觉控制区的激活。电针心经穴组功能连接特异性增强和新增脑区主要与认知、情感、记忆等高级认知功能相关,也包括与心血管功能相关的脑区,这些脑区的功能与心经穴的功能主治有紧密联系,推测电针心经穴对与高级认知功能及心血管功能等相关脑区功能连接的影响可能是其治疗精神、神志类及心血管疾病的中枢机制之一。

Objective To observe the changes of brain rest-state functional connectivity following electroacupuncture （EA） stimulation of right Xia-Jiquan （HT 1）, Shaohai （HT 3）, Lingdao （HT 4） and Shenmen （HT 7） of the Heart Meridian and non-acupoints in healthy volunteers so as to provide an imaging basis for clinical treatment of some related disorders. Methods A total of 20 healthy volunteers who met the inclusion criteria were randomly divided into HT-acupoint group （n = 10 cases） and non-acupoint group （n= 10 cases） according to the visiting sequence. EA （2 Hz, 2-5 mA） was applied to the right HT 1-HT 3, and HT 4-HT 7 （two outputs of the EA stimulater being connected to two acupuncture needle handles） and non-acupoints （4 spots on the imaginary mid-line between the HT and the Pericardium Meridian apart from the 4 acupoints HT 1-HT 3, and HT 4-HT 7） for 6 min. All the subjects underwent resting-state （rs） fMRI using an Achieva 1.5 T magnetic resonance image （MRI） scanner before and after EA stimulation. The bilateral posterior cingulate was used as the seed point and the functional connectivity data was analyzed by using DPARSF software and rs-fMRI data analysis toolkit. Results After EA stimulation of both acupoints and non-acupoints, a similar functional connectivity change was found in the bilateral postcentral gyrus, right inferior parietal Iobule, and right inferior frontal gyrus. After EA of acupoints of the HT Meridian, an enhancement of brain functional connectivity was found in the left inferior temporal gyrus and right parahippocampal gyrus, and the newly activated brain regions were the left precentral gyrus, right precuneus, left angular gyrus, left inferior occipital gyrus and the left insula. After EA stimulation of non-acupoints, an increased functional connectivity was found in the left superior temporal gyrus, which was different from EA of acupoints of HT Meridian. Conclusion EA stimulation of acu- points of the HT Meridian can enhance the rs functional connectivity in some brain regions as the postcentral gyrus, inferior temporal gyrus, etc. which is related to mediating information of somatosensory, cognitive, affective, memory, cardiovascular activities, etc. in healthy volunteer subjects. The only difference between the two EA groups is an enhanced functional connectivity found in the left superior temporal gyrus after EA of non-acupoints.