针刺阳陵泉穴对缺血性卒中患者百分比振幅变化的影响

Effect of acupuncture at Yanglingquan(GB34) on the changes of percent amplitude of fluctuation in ischemic stroke patients

目的 基于功能性磁共振成像(functional magnetic resonance imaging,fMRI)技术,观察针刺阳陵泉对右侧缺血性卒中患者百分比振幅(percent amplitude of fluctuation,PerAF)变化的影响。方法 纳入右侧缺血性卒中患者28例(观察组),并募集与患者性别和年龄相匹配的健康受试者28例(对照组)。观察组分别进行静息态及针刺阳陵泉后静息态fMRI扫描,对照组仅进行静息态fMRI扫描。计算两组全脑体素的PerAF。结果观察组静息态左侧楔前叶PerAF值高于对照组静息态(GRF校正,体素水平P<0.001,团块水平P<0.05,双尾);观察组针刺后左侧楔前叶PerAF值与对照组静息态比较有升高有降低(GRF校正,体素水平P<0.001,团块水平P<0.05,双尾),观察组针刺后左侧枕中回、右侧角回和右侧中扣带回PerAF值较对照组静息态降低(GRF校正,体素水平P<0.001,团块水平P<0.05,双尾)。观察组针刺后右侧中扣带回PerAF值较观察组静息态降低(GRF校正,体素水平P<0.001,团块水平P<0.05,双尾)。结论 右侧缺血性卒中患者静息态左侧楔前叶PerAF值高于健康者,针刺阳陵泉穴可调节右侧缺血性卒中患者多个脑区PerAF值,右侧中扣带回可能是其发挥脑效应机制潜在脑区。

Objective To observe the effect of acupuncture at Yanglingquan(GB34) on the changes of percent amplitude of fluctuation(PerAF) in patients with right-side ischemic stroke based on the functional magnetic resonance imaging(fMRI) technique.Method Twenty-eight patients with right-side ischemic stroke were recruited as an observation group.Another 28 healthy volunteers matched in age and gender were enrolled as a control group.The observation group was detected using the fMRI at the resting state before and after acupuncture at Yanglingquan,and the control group only underwent resting-state fMRI examination.The PerAF of whole-brain voxel was calculated for each group.Result The left precuneus PerAF at the resting state was larger in the observation group than in the control group(GRF correction,the level of voxel P<0.001,the level of mass P<0.05,two-tailed);the left precuneus PerAF after acupuncture in the observation group was either larger or smaller than the resting-state PerAF in the control group(GRF correction,the level of voxel P<0.001,the level of mass P<0.05,two-tailed),and the PerAF values of the left occipital gyrus,right angular gyrus,and right midcingulate in the observation group after acupuncture were smaller than those in the control group(GRF correction,the level of voxel P<0.001,the level of mass P<0.05,two-tailed).In the observation group,the right midcingulate PerAF at the resting state became smaller after acupuncture(GRF correction,the level of voxel P<0.001,the level of mass P<0.05,two-tailed).Conclusion Patients with right-side ischemic stroke have a larger PerAF value in the left precuneus at the resting state than healthy people.Acupuncture at Yanglingquan can regulate the PerAF value in multiple brain regions in patients with right-side ischemic stroke,and the right midcingulate may be the potential brain region for acupuncture to play its role.