| 易小琦,黄俊浩,陈暇女,郭定波,余娇艳,王 娟,王振宇,杜 瑛,胡良波.针刺促进缺血性脑卒中功能恢复的静息态功能连接研究[J].中国康复医学杂志,2021,(4):383~387 |
| 针刺促进缺血性脑卒中功能恢复的静息态功能连接研究 点此下载全文 |
| 易小琦 黄俊浩 陈暇女 郭定波 余娇艳 王 娟 王振宇 杜 瑛 胡良波 |
| 重庆医科大学附属永川医院放射科，重庆，402160 |
| 基金项目：国家自然科学基金面上项目（81674066）；重庆市卫计委医学科研计划重点项目（2017ZDXM020）；重庆市卫计委中医药项目（zy201602119） |
| DOI：10.3969/j.issn.1001-1242.2021.04.001 |
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| 摘要： |
| 摘要
目的：采用静息态功能磁共振（rs-fMRI）观察缺血性脑卒中脑功能连接（FC）的特点，并探讨针刺治疗在脑卒中功能恢复中可能存在的重塑机制。
方法：纳入脑卒中伴右侧肢体运动功能障碍患者21例（脑卒中组）和健康受试者18例（健康对照组）。采集脑卒中组治疗前后Fugl-Meyer量表（FMA）评分及所有受试者的rs-fMRI数据，选取双侧初级运动皮质（M1）为种子点，比较脑卒中组和对照组双侧M1区与全脑的FC差异,并将差异脑区FC值与FMA评分作相关性分析。
结果：脑卒中患者在针刺治疗后FMA评分明显提高（t=-8.595,P＜0.001）。脑卒中组治疗前与健康对照组比较，左侧M1区FC减弱的脑区主要有右侧中央前回、右侧额上回、左侧中央后回等，但Cerebelum_6_区FC增强。右侧M1区FC减弱的脑区主要有左侧中央前回、左侧中央后回、右侧顶下缘角回等，但Cerebelum_Crus2_R区FC增强。脑卒中组针刺治疗前后比较，左侧M1区FC增强的脑区有右侧中央前回、右侧额中回，FC减弱的脑区有左侧颞中回、左侧前扣带和旁扣带脑回。右侧M1区FC增强的脑区有右侧中央前回、右侧中央后回、右侧颞中回。脑卒中组针刺后右侧中央前回的FC值与治疗后FMA评分呈明显正相关(r=0.523,P=0.015)。
结论：针刺可有效促进缺血性脑卒中患者的功能恢复。针灸后双侧M1区与右侧中央前回和额中回的FC显著增强，这可能是针刺促进脑卒中患者运动功能恢复的重塑机制。 |
| 关键词：针刺 脑卒中 运动功能 静息态功能磁共振 功能连接 |
| Effects of acupuncture in functional recovery of ischemic stroke: a resting-state fMRI study Download Fulltext |
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| Yongchuan Hospital of Chongqing Medical University, Chongqing, 402160 |
| Fund Project: |
| Abstract: |
| Abstract
Objective：To observe the characteristics of functional connectivity(FC) in ischemic stroke and to explore the possible remodeling mechanism of acupuncture therapy in functional recovery of stroke using resting-state functional magnetic resonance imaging (rs-fMRI).
Method：Twenty-one stroke patients with right limb movement dysfunction (stroke group) and 18 healthy subjects (healthy control group) were enrolled. The primary motor cortex (M1) was selected as the seed point to compare the differences of FC between the bilateral M1 region and the whole brain in two group. Pearson correlation analysis was performed on the abnormal FCS and FMA scores.
Result：FMA scores were significantly improved in stroke patients after acupuncture treatment（t=-8.595,P＜0.001）. Compared with the healthy control group, the patients in stroke group before treatment showed the extensively weak FCS between the left M1 area and the right central anterior gyrus, the right frontal gyrus, and the left central posterior gyrus, but the Cerebelum_6_L was enhanced. FCS were reduced between the right M1 region and the left central anterior gyrus,the left central posterior gyrus, and the right lower marginal horn, but the Cerebelum_Crus2_R was enhanced. When compared the FCS between before and after acupuncture treatment in the stroke group, they were enhanced between the left M1 region and the right central anterior gyrus, the right frontal gyrus, but the left medial temporal gyrus and the left anterior cingulate and the paracingulate gyrus were reduced. FCS were enhanced between the right M1 region and the right anterior central gyrus, the right posterior central gyrus, and the right middle temporal gyrus. FCS of the right anterior central gyrus after acupuncture were positively correlated with FMA scores after treatment in the stroke group(r=0.523,P=0.015).
Conclusion：Acupuncture can effectively promote functional recovery in patients with ischemic stroke. After acupuncture, FCS between bilateral M1 area and the right anterior central gyrus and the middle frontal gyrus were significantly enhanced, which may be one of the brain remodeling mechanisms for acupuncture to improve motor function in patients with stroke. |
| Keywords:acupuncture stroke motor function resting-state functional magnetic resonance functional connectivity |
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