Structural and functional connectivity of the whole brain and subnetworks in individuals with mild traumatic brain injury:predictors of patient prognosis

Patients with mild traumatic brain injury have a diverse clinical presentation,and the underlying pathophysiology remains poorly understood.Magnetic resonance imaging is a non-invasive technique that has been widely utilized to investigate neuro biological markers after mild traumatic brain injury.This approach has emerged as a promising tool for investigating the pathogenesis of mild traumatic brain injury.G raph theory is a quantitative method of analyzing complex networks that has been widely used to study changes in brain structure and function.However,most previous mild traumatic brain injury studies using graph theory have focused on specific populations,with limited exploration of simultaneous abnormalities in structural and functional connectivity.Given that mild traumatic brain injury is the most common type of traumatic brain injury encounte red in clinical practice,further investigation of the patient characteristics and evolution of structural and functional connectivity is critical.In the present study,we explored whether abnormal structural and functional connectivity in the acute phase could serve as indicators of longitudinal changes in imaging data and cognitive function in patients with mild traumatic brain injury.In this longitudinal study,we enrolled 46 patients with mild traumatic brain injury who were assessed within 2 wee ks of injury,as well as 36 healthy controls.Resting-state functional magnetic resonance imaging and diffusion-weighted imaging data were acquired for graph theoretical network analysis.In the acute phase,patients with mild traumatic brain injury demonstrated reduced structural connectivity in the dorsal attention network.More than 3 months of followup data revealed signs of recovery in structural and functional connectivity,as well as cognitive function,in 22 out of the 46 patients.Furthermore,better cognitive function was associated with more efficient networks.Finally,our data indicated that small-worldness in the acute stage could serve as a predictor of longitudinal changes in connectivity in patients with mild traumatic brain injury.These findings highlight the importance of integrating structural and functional connectivity in unde rstanding the occurrence and evolution of mild traumatic brain injury.Additionally,exploratory analysis based on subnetworks could serve a predictive function in the prognosis of patients with mild traumatic brain injury.

Acupuncture at Waiguan (TE5) influences activation/deactivation of functional brain areas in ischemic stroke patients and healthy people A functional MRI study

In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan （TE5）. In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamiilary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11,20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.

Relationship between sonographically measured median nerve cross-sectional area and presence of peripheral neuropathy in diabetic subjects

BACKGROUND Neuropathy is a common complication of diabetes mellitus resulting from direct damage by hyperglycemia to the nerves and/or ischemia by microvascular injury to the endoneurial vessels which supply the nerves. Median nerve is one of the peripheral nerves commonly affected in diabetic neuropathy. The median nerve size has been studied in non-Nigerian diabetic populations. In attempt to contribute to existing literature, a study in a Nigerian population is needed.AIM To evaluate the cross-sectional area(CSA) of the median nerve using B-mode ultrasonography(USS) and the presence of peripheral neuropathy(PN) in a cohort of adult diabetic Nigerians.METHODS Demographic and anthropometric data of 85 adult diabetes mellitus(DM) and 85 age-and sex-matched apparently healthy control(HC) subjects were taken. A complete physical examination was performed on all study subjects to determine the presence of PN and modified Michigan Neuropathy Screening Instrument(MNSI) was used to grade its severity. Venous blood was taken from the study subjects for fasting lipid profile(FLP), fasting blood glucose(FBG) and glycated haemoglobin(HbA1 c) while their MN CSA was evaluated at a point 5 cm proximal to(5 cmCATL) and at the carpal tunnel(CATL) by high-resolution Bmode USS. Data was analysed using SPSS version 22.RESULTS The mean MN CSA was significantly thicker in DM subjects compared to the HC at 5 cmCATL(P < 0.01) and at the CATL(P < 0.01) on both sides. The presence of diabetic peripheral neuropathy(DPN) further increased the MN CSA at the CATL(P < 0.05) but not at 5 cmCATL(P > 0.05). However, the severity of DPN had no additional effect on MN CSA 5 cm proximal to and at the CATL. There was no significant association between MN CSA and duration of DM and glycemic control.CONCLUSION Thickening of the MN CSA at 5 cmCATL and CATL is seen in DM. Presence of DPN is associated with worse thickening of the MN CSA at the CATL but not at5 cmCATL. Severity of DPN, duration of DM, and glycemic control had no additional effect on the MN CSA.

Functional MRI activation of primary and secondary motor areas in healthy subjects

BACKGROUND： Functional MRI （fMRI） demonstrates the localization of hand representation in the motor cortex, thereby providing feasible noninvasive mapping of functional activities in the human brain. OBJECTIVE： To observe cortical activation within different cortical motor regions during repetitive hand movements in healthy subjects through the use of fMRI. DESIGN： An observational study, with each subject acting as his own control. SETTING： Department of Radiology, the First Affiliated Hospital of Nanchang University. PARTICIPANTS： Seven healthy volunteers, 4 males and 3 females, aged 19 to 38 years, participated in the study. All subjects were right-handed, with no neurological or psychological disorders. Informed written consent was obtained from all subjects, and the study was approved by the Institutional Review Board of the First Affiliated Hospital of Nanchang University. METHODS： The study was performed at the Department of Radiology between June-August 2005. A 1.5 Tesla Siemens MRI scanner （Symphony, Germany） was used to acquire T1-weighted structural images, which were oriented parallel to the line running through the anterior and the posterior commissures. Subjects were instructed on a task and were allowed to practice briefly prior to the imaging procedure. The motor activation task consisted of the right hand performing a clenching movement. The T1-W images were acquired from six alternating epochs of rest and activation from all seven healthy subjects. Data were collected with echoplanar imaging of brain oxygen level dependent （BOLD） sequence. Each series comprised six cycles of task performance （30 seconds）, alternating with rest （30 seconds） periods, and 3-second time intervals. The differences between active and baseline fMRI imaging were calculated using the student t-test. Differential maps were overlaid on the high resolution TI-W structural image for neuroanatomical correlation of activation areas. MAIN OUTCOME MEASURES： The omega-shaped hand knobs were recognized on T1-W structural images. Active signal changes in the primary （M1） and secondary motor （M2） areas, as well as the relationship between the hand knobs and M1 area activation, were analyzed. Region of interest was selected for signal change quantitative graphic analysis. RESULTS： All 7 enrolled volunteers were included in the final analysis. In the present study, hand knob structures were recognized on T1-weighted images in all subjects and were omega-shaped in the axial plane. Significant functional activations were observed in the contralateral primary motor area of all subjects. Activation signals were distributed mainly in the central sulcus around the hand knob. The contralateral primary sensory （S1） cortex was activated in most cases, and ipsilateral M1 was activated in 3 subjects. Contralateral or bilateral supplementary motor area （SMA） was also activated in 6 cases. Premotor area, or super parietal lobe, was activated in two subjects. Three-dimensional reconstruction demonstrated that the active signal of M1 was primarily located at the middle-lateral surface of the contralateral precentral gyrus in Brodman＇s area 4, and the signal of SMA activation was located in the mesial surface of the premotor area. CONCLUSION： The knob structure of the precentral gyrus is the representative motor area for hand movement. The cerebral cortical motor network was extensively activated during voluntary hand movements in normal subjects. In alert, conscious human subjects, the activated fMRI signal safely and non-invasively localized and lateralized the motor cortical activity associated with simple voluntary repetitive hand movements. Whether higher cognitive functions, such as perception and speech, can be similarly mapped using the fMRI technique and the BOLD method remains to be determined in future well-designed human studies.

Ultrasonographic measurement of median nerve cross-sectional area reference values in a healthy Han population from Guiyang,China

High-resolution ultrasonography was used to analyze the nerve cross-sectional area （CSA） of the median nerve at 7 sites： the wrist crease, pisiform bone, hamate bone, 6 cm proximal to the tip of the wrist crease, proximal forearm （where the nerve enters the pronator teres muscle）, 4 cm proximal to the tip of the medial epicondyle, and mid-humerus （mid-point between elbow crease and axilla） in 200 healthy volunteers from Guiyang, China. Results showed similar CSA values between the left and right sides, but the CSA 6 cm proximal to the tip of the wrist crease, proximal forearm, 4 cm proximal to tip of the medial epicondyle, and mid-humerus in males was greater than that of females. Moreover, CSA values at the wrist crease, pisiform bone, and hamate bone were greater in the middle-aged and old groups when compared to the young group, and correlated with body mass and height. Thus, reference values of median nerve CSA of the upper limbs can facilitate the analysis of abnormal nerve conditions.

Using negative exponential function to characterize built-up land density along slope gradient for 19 urban areas in China

In China,numerous cities are expanding into sloping land,yet the quantitative distribution patterns of urban built-up land density along the slope gradient remain unclear,limiting the understanding of sloping land urbanization.In this paper,a simple negative exponential function was presented to verify its applicability in 19 typical sloping urban areas in China.The function fits well for all case urban areas(R^(2)≥0.951,p<0.001).The parameters of this function clearly describe two fundamental attributes:initial value a and decline rate b.Between 2000 and 2020,a tends to increase,while b tends to decrease in all urban areas,confirming the hypothesis of mutual promotion between flatland densification and sloping land expansion.Multiple regression analysis indicates that the built-up land density and the ruggedness of background land can explain 70.7%of a,while the average slope ratio of built-up land to background land,the built-up land density and the built-up land area can explain 82.1%of b.This work provides a quantitative investigative tool for distribution of urban built-up land density along slope gradient,aiding in the study of the globally increasing phenomenon of sloping land urbanization from a new perspective.

Division of carbon sink functional areas and path to carbon neutrality in coal mines

Remote sensing image data of typical mining areas in the Loess Plateau from 1986 to 2018 were used to analyze the evolution of land use,explore the division of carbon sink functional areas,and propose carbon neutrality paths to provide a reference for the coal industry carbon peak,carbon-neutral action plan.Results show that(1)land use has changed signifcantly in the Pingshuo mining area over the past 30 years.Damaged land in industrial,opencast,stripping,and dumping areas comprises 4482.5 ha of cultivated land,1648.13 ha of grassland,and 963.49 ha of forestland.(2)The carbon sink functional areas of the Pingshuo mining land is divided into invariant,enhancement,low carbon optimization,and carbon emission control areas.The proportion of carbon sinks in the invariant area is decreasing,whereas the proportion in enhancement,low carbon optimization,and carbon emission control areas is gradually increasing.(3)The carbon neutrality of the mining area must be reduced from the entire process of stripping–mining–transport–disposal–reclamation,and carbon emissions and carbon sink accounting must start from the life cycle of coal resources.Therefore,carbon neutrality in mining areas must follow the 5R principles of reduction,reuse,recycling,redevelopment,and restoration,and attention must be paid to the potential of carbon sinks in ecological protection and restoration projects in the future.

Multi-source Data-driven Identification of Urban Functional Areas:A Case of Shenyang,China

Urban functional area(UFA)is a core scientific issue affecting urban sustainability.The current knowledge gap is mainly reflected in the lack of multi-scale quantitative interpretation methods from the perspective of human-land interaction.In this paper,based on multi-source big data include 250 m×250 m resolution cell phone data,1.81×105 Points of Interest(POI)data and administrative boundary data,we built a UFA identification method and demonstrated empirically in Shenyang City,China.We argue that the method we built can effectively identify multi-scale multi-type UFAs based on human activity and further reveal the spatial correlation between urban facilities and human activity.The empirical study suggests that the employment functional zones in Shenyang City are more concentrated in central cities than other single functional zones.There are more mix functional areas in the central city areas,while the planned industrial new cities need to develop comprehensive functions in Shenyang.UFAs have scale effects and human-land interaction patterns.We suggest that city decision makers should apply multi-sources big data to measure urban functional service in a more refined manner from a supply-demand perspective.

Activation of brain areas following ankle dorsiflexion versus plantar flexion Functional magnetic resonance imaging verification

Changes in activated areas of the brain during ankle active dorsiflexion and ankle active plantar flexion were observed in six healthy subjects using functional magnetic resonance imaging. Excited areas of ankle active dorsiflexion involved the bilateral primary motor area and the primary somatosensory area, as well as the bilateral supplementary sensory area, the primary visual area, the right second visual area, and the vermis of cerebellum. Excited areas of ankle active plantar flexion included the ipsilateral supplementary motor area, the limbic system, and the contralateral corpus striatum. Fine movements of the cerebral cortex control the function of the ankle dorsiflexion to a larger extent than ankle plate flexion, and the function of ankle plate flexion is more controlled by the subcortical area.

Non-concomitant cortical structural and functional alterations in sensorimotor areas following incomplete spinal cord injury

Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury（SCI）. The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI（mean age 40.94 ± 14.10 years old; male：female, 7：11） and 18 healthy subjects（37.33 ± 11.79 years old; male：female, 7：11） were studied by resting state functional magnetic resonance imaging. Gray matter volume（GMV） and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex（BA1） and left primary motor cortex（BA4）, and left BA1 and left somatosensory association cortex（BA5） was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry（registration number： Chi CTR-ROC-17013566）.

Bending and free vibrational analysis of bi-directional functionally graded beams with circular cross-section

The bending and free vibrational behaviors of functionally graded(FG)cylindrical beams with radially and axially varying material inhomogeneities are investigated.Based on a high-order cylindrical beam model,where the shear deformation and rotary inertia are both considered,the two coupled governing differential motion equations for the deflection and rotation are established.The analytical bending solutions for various boundary conditions are derived.In the vibrational analysis of FG cylindrical beams,the two governing equations are firstly changed to a single equation by means of an auxiliary function,and then the vibration mode is expanded into shifted Chebyshev polynomials.Numerical examples are given to investigate the effects of the material gradient indices on the deflections,the stress distributions,and the eigenfrequencies of the cylindrical beams,respectively.By comparing the obtained numerical results with those obtained by the three-dimensional(3D)elasticity theory and the Timoshenko beam theory,the effectiveness of the present approach is verified.

Does the ratio of the carpal tunnel inlet and outlet cross-sectional areas in the median nerve reflect carpal tunnel syndrome severity?

Although ultrasound measurements have been used in previous studies on carpal tunnel syndrome to visualize injury to the median nerve, whether such ultrasound data can indicate the severity of carpal tunnel syndrome remains controversial. The cross-sectional areas of the median nerve at the tunnel inlet and outlet can show swelling and compression of the nerve at the carpal. We hypothesized that the ratio of the cross-sectional areas of the median nerve at the carpal tunnel inlet to outlet accurately reflects the severity of carpal tunnel syndrome. To test this, high-resolution ultrasound with a linear array transducer at 5–17 MHz was used to assess 77 patients with carpal tunnel syndrome. The results showed that the cut-off point for the inlet-to-outlet ratio was 1.14. Significant differences in the inlet-to-outlet ratio were found among patients with mild, moderate, and severe carpal tunnel syndrome. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.29 between mild and more severe（moderate and severe） carpal tunnel syndrome patients with 64.7% sensitivity and 72.7% specificity. The cut-off point in the ratio of cross-sectional areas of the median nerve was 1.52 between the moderate and severe carpal tunnel syndrome patients with 80.0% sensitivity and 64.7% specificity. These results suggest that the inlet-to-outlet ratio reflected the severity of carpal tunnel syndrome.

Intraoperative awake anesthesia applied for tumor excision in cerebral functional areas

Objective:To observe the feasibility and safety of awake anesthesia for tumor excisions in pa- tients with brain tumors involving cerebral functional areas.Methods:Fifty patients with brain tumors in- volving cerebral functional areas,ASAⅠ-Ⅱgrade,were enrolled in this study.Propofol and remifentanil were used for total intravenous anesthesia,and a laryngeal mask airway(LMA)was inserted for the air- way opening and synchronized intermittent mandatory ventilation(SIMV).At the surgeon's request for an intraoperative wake-up test,the propofol infusion was stopped advance of 10-15 min,the remifentanil in- fusion rate was decreased to 0.050-0.075μg/kg from 0.10-0.20μg/kg per min for easing surgical pain. The LMA was removed until the patient awakened.The anesthesiologist then kept up an on-going neuro- logical examination.After that,anesthesia was re-deepened and LMA was re-inserted until the whole surgery was accomplished.Results:Forty-six of 50 patients(92%)were successfully awakened and 4 (8%)failed to complete the intraoperative wake-up test because of dyspnea,over-sedation,or severe hy pertension.No severe complications occurred during the whole process.Conclusions:During the awake anesthetic period,the intraoperative wake-up test combined with navigation,evoked potential and ultra- sound techniques can help surgeons excise maximumly and precisely the brain tumors near to or in the functional areas.

AREA INTEGRAL FUNCTIONS AND H∞ FUNCTIONAL CALCULUS FOR SECTORIAL OPERATORS ON HILBERT SPACES

Area integral functions are introduced for sectorial operators on Hilbert spaces. We establish the equivalence relationship between the square and area integral functions. This immediately extends McIntosh/Yagi＇s results on H∞ functional calculus of sectorial operators on Hilbert spaces to the case when the square functions are replaced by the area integral functions.

Preoperative functional MRI localization of language areas in Chinese patients with brain tumors Validation with intraoperative electrocortical mapping

Ten Chinese patients with brain tumors involving language regions were selected. Preoperative functional MRI was performed to locate Broca＇s or Wernicke＇s area, and the cortex that was essential for language function was determined by electrocortical mapping. A site-by-site comparison between functional MRI and electrocortical mapping was performed with the aid of a neuronavigation device. Results showed that the sensitivity and specificity of preoperative functional MRI were 80.0% and 85.0% in Broca＇s area and 66.6% and 85.2% in Wemicke＇s area, respectively. These experimental findings indicate that functional MRI is an accurate, reliable technique with which to identify the location of Wernicke＇s area or Broca＇s area in patients with brain tumors.

Usefulness of the acromioclavicular joint cross-sectional area as a diagnostic image parameter of acromioclavicular osteoarthritis

BACKGROUND Acromioclavicular joint(ACJ)space narrowing has been considered to be an important diagnostic image parameter of ACJ osteoarthritis(ACJO).However,the morphology of the ACJ space is irregular because of osteophyte formation,subchondral irregularity,capsular distention,sclerosis,and erosion.Therefore,we created the ACJ cross-sectional area(ACJCSA)as a new diagnostic image parameter to assess the irregular morphologic changes of the ACJ.AIM To hypothesize that the ACJCSA is a new diagnostic image parameter for ACJO.METHODS ACJ samples were obtained from 35 patients with ACJO and 30 healthy individuals who underwent shoulder magnetic resonance(S-MR)imaging that revealed no evidence of ACJO.Oblique coronal,T2-weighted,fat-suppressed SMR images were acquired at the ACJ level from the two groups.We measured the ACJCSA and the ACJ space width(ACJSW)at the ACJ on the S-MR images using our imaging analysis program.The ACJCSA was measured as the cross-sectional area of the ACJ.The ACJSW was measured as the narrowest point between the acromion and the clavicle.RESULTS The average ACJCSA was 39.88±10.60 mm;in the normal group and 18.80±5.13 mm;in the ACJO group.The mean ACJSW was 3.51±0.58 mm in the normal group and 2.02±0.48 mm in the ACJO group.ACJO individuals had significantly lower ACJCSA and ACJSW than the healthy individuals.Receiver operating characteristic curve analyses demonstrated that the most suitable ACJCSA cutoff score was 26.14 mm^(2),with 91.4%sensitivity and 90.0%specificity.CONCLUSION The optimal ACJSW cutoff score was 2.37 mm,with 88.6%sensitivity and 96.7%specificity.Even though both the ACJCSA and ACJSW were significantly associated with ACJO,the ACJCSA was a more sensitive diagnostic image parameter.

Correlation between current and cross-sectional area of parallel fixed-movable dual electrodes in ESC

Electroslag casting with parallel fixed-movable dual electrodes is a new method for achieving better quality of castings in complex mold cavities.In this work,a mathematical model,y=kx^2+(k+1)x,was established to describe the ideal correlation between the current ratio(y)and the cross-sectional area ratio(x)of the dual electrodes,where k is the filling ratio.Investigation was conducted on the electroslag casting process with dual electrodes of various cross-sectional areas,but at a constant k value.The experimental results indicated that the ideal correlation was obtained at the stable casting stage,and the fitting results were consistent with the experimental results at certain k values.The experimental findings show that better castings can be obtained when the current ratio is greater than 1.536 and the cross-sectional area ratio is greater than 0.5.

Industrial Policy Analysis of Restricted Development Zones in Western China——A Study of State-level Main Producing Areas of Agricultural Products and Key Ecological Functional Areas

As one of the important policies of promoting the formation of main functional areas, the industrial policy directly determines the sustainable growth of space control ability of main functional areas. A restricted development zone is a type of main functional area which provides agricultural products and ecological products, assures the supply of national agricultural products and the stability of ecosystems, as well as safeguards the ecological functions and agricultural functions of wider regions by restricting its own development. Therefore scientific, complete and operable industrial policy support is needed. Restricted development zones are distributed widely in western China. With the restriction of their main functions, differential industrial policies should be implemented in the development of the restricted development zones: Dealing well with the relationship between industrial development and ecological protection, developing special industries which are friendly to resources and environment and appropriate for local conditions, guiding and encouraging industries to learn from regions with favorable development conditions, orderly withdrawing industries and enterprises adverse to main functions, facilitating industrial structure upgrading, optimizing industrial organization, improving industrial technological level and rationalizing industrial layout.

Constrained Delaunay Triangulation for Grouping Functional Areas by Land Use

Functional land use maps are used for land evaluation, environmental analysis, and resource conservation. Spatial data clustering identifies the sparse and crowded places, thus discovering the overall distribution pattern of the dataset. Some clustering methods represent an attribute-oriented approach to knowledge discovery. Other methods rely on natural notions of similarities （e.g., Euclidean distances）. These are not appropriate for constructing functional areas. We propose a similarity value to evaluate the closeness between a pair of points based on the total functional area and the proportion of the main land use type for the entire functional area. We develop constrained attributes employing this similarity value and a DT （Delaunay triangulation） criterion function when merging clusters. Four thresholds are set to ensure that functional areas have acceptable proportions, regular shapes, and no overlap. An experimental study was conducted with cadastral data for Chengdu, China, from 2009. The results show the advantages for objectivity and efficiency in using the proposed algorithm to define functional areas. The areas are created dynamically at any convenient time.

Acupuncture at Waiguan(SJ5) and sham points influences activation of functional brain areas of ischemic stroke patients: a functional magnetic resonance imaging study

Most studies addressing the specificity of meridians and acupuncture points have focused mainly on the different neural effects of acupuncture at different points in healthy individuals. This study examined the effects of acupuncture on brain function in a pathological context. Sixteen patients with ischemic stroke were randomly assigned to true point group （true acupuncture at right Waiguan （SJ5）） and sham point group （sham acupuncture）. Results of functional magnetic resonance imaging revealed activation in right parietal lobe （Brodmann areas 7 and 19）, the right temporal lobe （Brodmann area 39）, the right limbic lobe （Brodmann area 23） and bilateral oc-cipital lobes （Brodmann area 18）. Furthermore, inhibition of bilateral frontal lobes （Brodmann area 4, 6, and 45）, right parietal lobe （Brodmann areas 1 and 5） and left temporal lobe （Brodmann area 21 ） were observed in the true point group. Activation in the precuneus of right parietal lobe （Brodmann area 7） and inhibition of the left superior frontal gyrus （Brodmann area 10） was observed in the sham group. Compared with sham acupuncture, acupuncture at Waiguan in stroke patients inhibited Brodmann area 5 on the healthy side. Results indicated that the altered specificity of sensation-associated cortex （Brodmann area 5） is possibly associated with a central mechanism of acupuncture at Waiguan for stroke patients.