耳甲电针对原发性失眠患者脑默认网络的即刻调节作用  

Instant adjustive effect of auricular electroacupuncture on brain default model network of patients with primary insomnia

作　　者：赵斌 李亮[1] 张金铃[1] 张磊[2] 王俊英[1] 王瑜 李少源[1] 侯理伟 方继良[2] 荣培晶[1] ZHAO Bin;LI Liang;ZHANG Jin⁃ling;ZHANG Lei;WANG Jun⁃ying;WANG Yu;LI Shao⁃yuan;HOU Li⁃wei;FANG Ji⁃liang;RONG Pei⁃jing(Institute of Acupuncture and Moxibustion,China Academy of Chinese Medical Sciences,Beijing 100700,China;Department of Radiology,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053)

机构地区：[1]中国中医科学院针灸研究所,北京100700 [2]中国中医科学院广安门医院放射科,北京100053

出　　处：《针刺研究》2019年第12期884-887,共4页Acupuncture Research

基　　金：国家重点研发计划(No.2018YFC1705800);国家自然科学基金面上项目(No.81473780);中国博士后科学基金资助项目(No.2019M650983);中国中医科学院针灸研究所自主选题项目(No.201814004)

摘　　要：目的:探讨耳甲电针对原发性失眠患者脑默认网络相关脑区功能连接的即刻调节作用。方法:纳入原发性失眠患者和健康志愿者各15例,患者予以耳甲电针治疗30 min,并采集治疗前后静息态功能磁共振数据,健康人只在纳入时采集静息态功能磁共振数据,运用基于种子点的功能连接分析方法,观察患者与健康人脑默认网络功能连接的差异,以及耳甲电针治疗后患者脑默认网络相关脑区功能连接的变化。结果:以后扣带回为种子点进行功能连接分析,患者治疗前与健康人比较,后扣带回与右侧脑岛、右侧岛盖部额下回、右侧中央沟盖功能连接增强。治疗后,患者后扣带回与楔前叶、左侧角回、左侧额上回、左侧额中回、右侧颞下回、右侧颞中回、左侧内侧眶额皮层的功能连接减弱,而与右侧舌回、右侧距状裂周围皮层的功能连接增强。结论:耳甲电针具有调制脑默认网络的即刻作用,这可能是其治疗原发性失眠的中枢机制。Objective To investigate the immediate brain effect of auricular electroacupuncture(EA)in the treatment of primary insomnia(PI).MethodsIn this study,15 subjects with PI who were diagnosed according to Pitsburgh Sleep Quality Index(PSQI),and other 15 age-and gender-matched subjects without insomnia were recruited in the present study.The PI patients received EA(4 Hz/20 Hz,a tolerable electrical current strength)of auricular concha for 30 min,and their resting state functional magnetic resonance imaging(fMRI)data before and after treatment were collected.The healthy subjects received no any treatment and their resting state fMRI data were collected.The difference of default mode network functional connectivity between the patients and healthy subjects,and changes of the patient’s brain functional connectivity after EA treatment were estimated by using seed-point-based analysis(SPBA).ResultsAnalysis by taking the posterior cingulate gyrus as the seed-point showed that compared with the healthy participants before treatment,the patient’s brain functional connectivity between the posterior cingulate gyrus and the right insula,or the inferior frontal gyrus of the right opercularis region,or the right rolandic operculum was increased.After 30 minutes’EA treatment,the functional connectivity between the posterior cingulate gyrus and the precuneus,the left angular gyrus,the left frontal superior gyrus,the left frontal middle cortex,the right temporalis inferior gyrus,the right temporalis middle gyrus or the left medial orbitofrontal cortex was decreased,while the functional connectivity between the posterior cingulate gyrus and the right lingual gyrus,or the cortex surrounding the right calcarine fissure was increased.ConclusionEA of auricular concha has an instant effect in modulating the brain default mode network in PI patients,which may be its brain mechanism underlying improvement of PI.

关 键 词：耳甲电针 原发性失眠 即刻调节作用 静息态功能磁共振 脑默认网络 

分 类 号：R245.32[医药卫生—针灸推拿学]