针刺合谷穴激发前额叶BOLD信号与γ-氨基丁酸含量变化的多模态fMRI研究  

Correlation between blood oxygen level dependent fMRI signal and GABA content in anterior cingulate cortex after acupuncture of Hegu(LI4)

作　　者：孙黎[1] 陈媛媛[1] 方继良[1] 洪洋[1] 王寅[2] 许可 李小娇[1] 陈丽梅 张国雷 赵彦萍[1] SUN Li;CHEN Yuan⁃yuan;FANG Ji⁃liang;HONG Yang;WANG Yin;XU Ke;LI Xiao⁃jiao;CHEN Li⁃mei;ZHANG Guo⁃lei;ZHAO Yan⁃ping(Department of Radiology,Guang’anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China;Department of Acupuncture⁃moxibustion,Guang’anmen Hospital of China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院放射科,北京100053 [2]中国中医科学院广安门医院针灸科,北京100053

出　　处：《针刺研究》2019年第12期878-883,892,共7页Acupuncture Research

基　　金：国家自然科学基金面上项目(No.81774433、81273674);国家科技部重点研发计划(No.2018YFC1705802);中国中医科学院广安门医院院级科研基金(No.2017s395)

摘　　要：目的:"面口合谷收"的大脑机制尚未明确,本研究通过观察针刺右侧合谷穴时前额叶脑皮层血流的血氧水平依赖功能磁共振成像(BOLD-fMRI)信号与相应皮层内磁共振波谱(MRS)检测到的神经递质γ-氨基丁酸(GABA)变化的关系,探索针刺合谷穴的作用机制。方法:本研究共招募到76名青年健康受试者,男23名,女53名,平均年龄(24.5±1.4)岁。受试者接受两次fMRI-MRS扫描,手针针刺和Von Frey纤毛针表皮刺激右侧合谷穴,两种刺激方式顺序随机分配,两次间隔1周。扫描序列含任务前静息态BOLD、MRS和任务态BOLD、MRS。感兴趣区(ROI)定位于双侧前额叶内侧皮层。fMRI数据采用SPM12、REST软件进行处理,MRS数据采用LC Model软件处理。随后进行脑激活区的组内、组间比较,计算ROI内皮层BOLD信号定量值,测量ROI内GABA值并进行矫正。最后统计分析BOLD信号与GABA含量的关系。结果:手针针刺与Von Frey纤毛针表皮刺激均诱发了大脑皮层广泛的BOLD负激活信号,主要集中在中线区(包含前额叶内侧皮层)和边缘叶脑区,但Von Frey纤毛针表皮刺激诱发的信号较少而弱。两组前额叶内侧皮层ROI内的BOLD信号与GABA+值在基线、任务后及其前后的差值均未发现明显相关性(手针针刺组:r=-0.07,-0.08,0.04;P=0.57,0.88,0.74;Von Frey纤毛针表皮刺激组:r=-0.10,-0.09,-0.01;P=0.43,0.46,0.96)。结论:手针针刺较Von Frey纤毛针表皮刺激合谷穴激发了更强更广的包含前额叶内侧皮层的边缘叶-旁边缘叶-新皮层网络负激活效应,但两种刺激下的前额叶内侧皮层ROI区域内BOLD信号与GABA含量及其变化未发现明确相关性,需进一步扩大样本量及在疾病状态下研究证实。Objective To explore the correlation between blood oxygen level dependent functional magnetic resonance imaging(BOLD-fMRI)signal and neurotransmitterγ-aminobutyric acid(GABA)concentration in the prefrontal cortex area after acupuncture or Von Frey filament stimulation(epidermal stimulation)at the right Hegu(LI4).MethodsA total of 76 healthy volunteers(23 men and 53 women,24.5±1.4 years in age)were recruited in the present study.Each volunteer received two sessions of fMRI magnetic resonance scanning(MRS)examinations,with an interval of one week between two sessions.The MRI scan sequences included pre-task MRS,resting state BOLD and task MRS,BOLD.A region of Interest(ROI)of 35 mm×30 mm×25 mm was located at the bilateral medial prefrontal cortex areas.In the two sessions of examinations,the right LI4 point was stimulated by manual acupuncture or Von Frey filament-pressing.The tasks were designed as the block design.Each block contained 3 intermittent acupoint stimulations,lasting 30 s in each stimulation and with two minutes’pause between two stimulations.The MRS data were processed by using Linear Combination(LC)Model software(for assessing GABA content),and the BOLD data of fMRI was analyzed by using SPM12 software(comparison within each group),REST1.8(comparison between two groups),separately.ResultsExtensive deactivations were induced by both stimulations,mainly involving the midline regions as the medial prefrontal lobe,and limbic lobe.The deactivation effect of manual acupuncture stimulation was more extensive and intensive than that of Von Frey filament stimulation,especially in the medial prefrontal lobe.Data from 66 volunteers(after exclusion of 10 participants due to bigger standard deviation of GABA/Glx)showed no marked correlation between the GABA concentration and BOLD activation in the anterior cingulate cortex area in both groups(manual acupuncture stimulation group:r=-0.07,-0.08,0.04;P=0.57,0.88,0.74;Von Frey filament epidermal stimulation group:r=-0.10,-0.09,-0.01;P=0.43,0.46,0.96).Conclusion

关 键 词：手针针刺 Von Frey纤毛针表皮刺激 合谷 血氧水平依赖功能磁共振成像 磁共振扫描 Γ-氨基丁酸 前扣带回 

分 类 号：R245.31[医药卫生—针灸推拿学]