| 涂秋月,贺子毅,梁展眸,邹绮文,李幸林,刘健华.电针调控运动学习任务的感觉运动通路差异性研究：一项经颅磁刺激研究[J].中国康复医学杂志,2026,(8):1228~1235 |
| 电针调控运动学习任务的感觉运动通路差异性研究：一项经颅磁刺激研究 点此下载全文 |
| 涂秋月 贺子毅 梁展眸 邹绮文 李幸林 刘健华 |
| 广州中医药大学第二临床医学院，广东省广州市，510120 |
| 基金项目：国家自然科学基金资助项目（81873381） |
| DOI：10.3969/j.issn.1001-1242.2026.08.006 |
| 摘要点击次数: 79 |
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| 摘要： |
| 摘要
目的：探究电针（electroacupuncture， EA）改善运动学习功能的神经通路，重点阐明其对两种典型运动学习任务（凹槽钉板测试与序列反应时任务）存在差异性调控，为EA在运动功能康复中的精准临床应用提供神经科学依据。
方法：采用随机交叉试验设计，30例右利手健康受试者随机分为两组试验。试验1中，15例受试者随机先后接受以下4种干预方案：EA刺激、假EA刺激、抑制初级体感皮层（the primary somatosensory cortex， S1） 后给予EA刺激及抑制次级体感皮层（the secondary somatosensory cortex， S2） 后给予EA刺激。每种干预间隔1周以上洗脱期。于每次干预前后分别评估以下指标：凹槽钉板测试（grooved pegboard test， GPT）表现、运动诱发电位（motor evoked potential， MEP）及S1区的体感诱发电位（somatosensory evoked potential， SEP）。试验2中，15例受试者随机先后接受以下4种干预方案：EA刺激、假EA刺激、抑制S1后给予EA刺激及抑制背侧前运动皮层（dorsal premotor cortex， PMd）后给予EA刺激。每种干预间隔1周以上洗脱期。于每次干预前后分别评估以下指标：序列反应时任务（serial reaction time task，SRTT）表现、MEP及PMd区的SEP。
结果：试验1显示，与假EA相比，EA显著改善GPT表现（P<0.001），同时增强M1兴奋性（P<0.001）和S1反应波幅（P<0.001）。然而，当抑制S1/S2兴奋性后，EA未能兴奋M1（P>0.05），且GPT表现亦无显著改善（P>0.05）。试验2发现，EA组在错误次数（F=6.160，P<0.05）、平均反应时（F=5.616，P<0.05）和最短反应时（F=21.763，P<0.01）的改善程度均显著优于假EA组；EA除增强S1和M1兴奋性外，还可提高PMd兴奋性（P<0.001）。抑制PMd后，EA既不能改善SRTT表现（P>0.05），也无法增强M1兴奋性（P>0.05）；而抑制S1后，EA仍能激活PMd（P<0.001）及显著改善SRTT错误次数（P<0.05）、平均反应时（P<0.001）和最短反应时（P<0.001）。
结论：EA可通过不同神经通路改善特定类型的运动学习表现：对于感觉运动任务，EA的促进作用依赖于“S1/S2-M1”通路；对于序列反应时任务，EA的改善作用则通过“PMd-M1”通路实现。 |
| 关键词：电针 运动学习任务 感觉运动通路 经颅磁刺激 |
| Differential sensorimotor pathway of electroacupuncture on motor learning tasks： a transcranial magnetic stimulation study Download Fulltext |
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| The Second Clinical College，Guangzhou University of Chinese Medicine，Guangzhou，510120 |
| Fund Project: |
| Abstract: |
| Abstract
Objective： To investigate the neural pathways through which electroacupuncture （EA） enhances motor learning function, with particular emphasis on its differential regulatory effects of EA on two standardized motor learning tasks—the grooved pegboard test (GPT) and the serial reaction time task (SRTT). This may provide a neuroscientific evidence for its targeted application in motor rehabilitation.
Method： This randomized crossover trial enrolled thirty right-handed healthy participants randomly allocated to two experimental groups （n=15 each）. In Experiment 1， 15 subjects were randomly assigned to receive the following four intervention protocols in sequence： EA， sham EA， EA following inhibition of the primary somatosensory cortex （S1）， and EA following inhibition of the secondary somatosensory cortex （S2）. Each intervention was separated by a washout period of more than one week. The following indicators were evaluated before and after each intervention： GPT performance， motor evoked potential （MEP）， and somatosensory evoked potential （SEP） of S1. In Experiment 2， 15 subjects were randomly assigned to receive the following four intervention protocols in sequence： EA， sham EA， EA following inhibition of S1， and EA following inhibition of the dorsal premotor cortex （PMd）. Each intervention was separated by a washout period of more than one week. The following indicators were evaluated before and after each intervention： SRTT performance， MEP， and SEP of PMd.
Result： Experiment 1 showed EA significantly improved GPT performance（P<0.001），enhanced M1 excitability（P<0.001） and S1 response amplitude（P<0.001） compared with sham EA. However， when S1/S2 excitability was inhibited， EA failed to excite M1（P>0.05）， and GPT performance did not show significant improvement（P>0.05）. Experiment 2 found that the EA group showed significantly better improvements in error count（F=6.160，P<0.05）， average reaction time（F=5.616，P<0.05）， and minimum reaction time（F=21.763，P<0.01） compared to the sham EA group. In addition to enhancing S1 and M1 excitability， EA also increased PMd excitability（P<0.001）. After inhibiting PMd， EA neither improved SRTT performance（P>0.05） nor enhanced M1 excitability（P>0.05）； however， after inhibiting S1， EA still activated PMd（P<0.001） and significantly improved SRTT error count（P<0.05）， average reaction time（P<0.001）， and minimum reaction time（P<0.001）.
Conclusion： EA can improve the performance of specific types of motor learning through different neural pathways： for sensorimotor tasks， the promoting effect of EA relies on the "S1/S2-M1" pathway； for the serial reaction time task， the improvement effect of EA is achieved through the "PMd-M1" pathway. |
| Keywords:electroacupuncture motor learning task sensorimotor pathway transcranial magnetic stimulation |
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