太极拳对慢性疲劳综合征患者左额顶网络功能连接度的影响

Effect of Tai Chi Exercise on Functional Connections of Left Frontoparietal Network in Patients with Chronic Fatigue Syndrome

目的从左额顶网络(LFPN)的功能连接度(FC)这一角度揭示太极拳对于治疗慢性疲劳综合征(CFS)的中枢作用机制。方法招募20例CFS患者和20名健康受试者,两组受试者均接受为期4周的简化24式太极拳训练。在治疗前后进行疲劳量表-14(FS-14)、汉密尔顿抑郁量表(HAMD)评分及功能磁共振成像技术(fMRI)扫描,并进行自身比较及组间比较;将患者治疗前后量表差值与功能连接度差值进行相关性分析。结果CFS患者的FS-14评分、HAMD评分显著高于健康受试者(P<0.01),治疗后量表评分均降低(P<0.01);CFS患者在LFPN区域的功能连接度明显偏低;经太极拳治疗后,功能连接度显著增强的脑区包括背侧前额叶、顶上小叶等,特别是左额下回、左前扣带回和内侧前额叶区域,健康受试者治疗后在右内侧颞叶、右背侧前额叶的功能连接度显著增强;CFS患者治疗前后LFPN功能连接度差值与FS-14差值之间呈负相关(r=-0.791,P<0.001),与HAMD差值之间无相关性(r=0.0273,P=0.9)。结论太极拳主要通过加强LFPN的功能连接度,特别是调节左额下回、左前扣带回和内侧前额叶区域的功能活动,达到改善CFS患者疲劳程度的临床效果。这种发现可促进对太极拳治疗CFS价值的理解。

Objective To explore the central mechanism ofTai Chi in the treatment of chronic fatigue syndrome(CFS)from the perspective of functional connectivity(FC)of left frontoparietal network(LFPN).Methods 20 CFS patients and 20 healthy subjects were recruited in this study.Both groups of subjects received simplified 24-form Tai Chi training for 4 weeks.Fatigue Scale-14(FS-14),Hamilton Depression Scale(HAMD)scores and functional-MRI scans were performed before and after treatment in self-comparison and inter-group comparison.The correlation between scale and FC before and after treatment was analyzed.Results 1)The FS-14、HAMD score of CFS patients were significantly higher than healthy subjects(P<0.01),and then decreased(P<0.01).2)The FC in the LFPN was significantly lower in CFS patients,and then was significantly enhanced in the dorsal prefrontal lobe and parietal lobule,especially in the left inferior frontal gyrus,left anterior cingulate gyrus and medial prefrontal lobe.The FC in the right medial temporal lobe and right dorsal prefrontal lobe was significantly enhanced in healthy subjects after treatment.3)The FC difference of LFPN before and after treatment in CFS patients was negatively correlated with the difference of FS-14(r=-0.791,P<0.001),and had no correlation with the difference of HAMD(R=0.0273,P=0.9).Conclusion Tai Chi can improve the fatigue degree of CFS patients by strengthening the FCof LFPN,particularly regulating the functional activities of left inferior frontal gyrus,left anterior cingulate gyrus and medial prefrontal cortex.These findings could advance our understanding of treatment of Tai Chi.