针刺干预慢性颈痛的静息态脑功能磁共振成像研究进展

Research Progress on Resting State-Functional Magnetic Resonance Imaging of Acupuncture Intervention in Chronic Neck Pain

[目的]总结近年来静息态脑功能磁共振成像(resting state-functional magnetic resonance imaging,rs-fMRI)在针刺干预慢性颈痛中的研究进展。[方法]以“慢性颈痛”“针刺”“fMRI”为检索词,通过中国知网、万方、PubMed等数据库检索近5年来国内外针刺干预慢性颈痛的rs-fMRI的研究文献,分析针刺对慢性颈痛患者脑功能调节特点。[结果]岛叶、前扣带回、前额皮质、杏仁核等“疼痛矩阵”的脑功能改变与慢性颈痛的发生与情绪体验密切相关。岛叶、前扣带回、前额皮质、杏仁核、中脑导水管周围灰质等功能核团是针刺缓解慢性颈痛疼痛程度及改善负性情绪的关键脑区。[结论]针刺通过调节慢性颈痛相关的感觉-情感-认知相关的脑功能区发挥治疗作用,利用rs-fMRI观察治疗前后关键脑区的信号变化及功能连接,不仅能够客观评价针灸治疗慢性颈痛的临床疗效,还能进一步探究其神经影像学机制,有望为后续制定个体化治疗方案、提高临床疗效提供新的思路与手段。

[Objective]To summarize the research progress on resting state-functional magnetic resonance imaging(rs-fMRI)of acupuncture intervention in chronic neck pain in recent years.[Methods]The imaging changes of functional nuclei and network connectivity in chronic neck pain during the acuncture treatment under fMRI are summaried by querying the newly years of the domestic and foreign literatures from China National Knowledge Internet(CNKI),WanFang,PubMed,etc,with“chronic neck pain”“acupuncture”and“fMRI”as the search terms.[Results]The“pain matrix”such as insula,anterior cingulate gyrus,prefrontal cortex and amygdala are closely related to the occurrence of chronic neck pain and emotional experience.Insula,anterior cingulate gyrus,prefrontal cortex,amygdala,periaqueductal,etc.are the key brain regions for acupuncture to relieve the chronic neck pain and relieve negative emotions.[Conclusion]Acupuncture plays a therapeutic role by regulating the sensory-emotional-cognitive functional brain regions related to chronic neck pain.And observing the imaging changes and functional connectivity of key brain regions during the acupuncture treatment based on rs-fMRI can not only evaluate the clinical efficacy of acupuncture treatment in chronic neck pain objectively,but also further explore its neuroimaging mechanism.It is expected to provide new therapeutic ideas and means for developing individualized treatment strategies and improving clinical efficacy.