针刺对脑白质疏松轻度认知障碍功能磁共振的影响  

Impact of Acupuncture on Functional Magnetic Resonance Imaging in Leukoaraiosis with Mild Cognitive Impairment

作　　者：侯小兵[1] 张允岭[2] 刘明[2] 周丽[2] 

机构地区：[1]中国中医科学院望京医院,北京100102 [2]北京中医药大学东方医院,北京100072

出　　处：《世界中西医结合杂志》2010年第2期122-125,共4页World Journal of Integrated Traditional and Western Medicine

基　　金：北京市新医药学科群建设项目(No.xk100270569);首都医学发展科研基金联合攻关项目(No.SF-2005-3);2008年中医药行业科研专项(No.200807011)

摘　　要：目的观察针刺前后脑白质疏松轻度认知障碍的脑功能磁共振变化,探索针刺干预轻度认知障碍的作用机理和疗效的客观化标准。方法以脑白质疏松轻度认知障碍为研究对象,以功能磁共振为研究手段,参考临床实际情况,长时程针刺干预,通过神经心理学量表评价脑白质疏松轻度认知障碍的临床变化。结果针刺前听觉任务激活的脑区包括颞叶的颞上回(BA22)、颞中回(BA21)、颞极区(BA38),额叶的体感皮层(BA1)和前运动皮层(BA6)。针刺后激活的脑区包括颞叶的颞上回(BA22),额叶的额眶叶(BA11)、额极区(BA10)、额叶被盖。被激活脑区明显少于针刺前被激活区。结论LACI相关的脑功能区涉及到额、颞叶,表现为执行听觉任务时颞叶皮质激活增多,前额叶皮质未激活;长时程针刺后颞叶皮质激活减少,前额叶皮质激活。fMRI可以为轻度认知障碍的诊断、疗效判断以及针刺作用机理研究提供可视化依据。长时程针刺可以作为LACI的有效干预手段之一,能够减少被激活脑区,提高任务刺激加工效率。Objective To observe brain functional magnetic resonance imaging（fMRI）changes in leukoaraiosis with mild cognitive impairment before and after acupuncture and explore the mechanism and the objective criteria of the efficacy of acupuncture intervention on mild cognitive impairment. Methods Leukoaraiosis with mild cognitive impairment（LACI）cases were taken as the subjects in the research. fMRI was applied as the means. In reference with clinical practical conditions,long-term acupuncture intervention and neuropsychological scale,the clinical changes in LACI were evaluated. Results Before acupuncture,the activated brain areas included the superior temporal gyrus（BA22）,the middle temporal gyrus（BA21）,the temporal polar area（BA38）;the prefrontal cortex,the somatosensory（BA1）and the anterior motor cortex（BA6）when the music hearing task started. After acupuncture,the activated brain areas included the superior temporal gyrus（BA22）;the orbital frontal lobe（BA11）,the frontal polar area（BA10）and the tegmentum of frontal lobe. The activated areas after acupuncture were less apparently than those before acupuncture. Conclusion The relevant brain function areas in LACI include the frontal and temporal lobes,manifested as the enhanced activation of the temporal cortex in the execution of hearing task and non-activation of the anterior frontal cortex. After the long-term acupuncture,the activation of the posterior temporal cortex decreases and the anterior frontal cortex is activated. fMRI can be the evidence for the diagnosis,the evaluation of efficacy as well as the research of acupuncture mechanism in mild cognitive impairment. Long-term acupuncture can be one of the effective intervention means for LACI and it can reduce the activated brain areas and improve the processing efficiency of the task stimulation.

关 键 词：中医内科学 针刺 轻度认知障碍 功能磁共振 

分 类 号：R749.16[医药卫生—神经病学与精神病学]