耳甲电针治疗复发性抑郁症即刻脑效应的fMRI初步研究  

Preliminary fMRI study on the immediate effect of transcutaneous auricular vagus nerve stimulation in the treatment of recurrent depression

作　　者：孙继飞 何家恺 陈丽梅 王智 郭春蕾 马跃 罗屹 李小娇[1] 许可 刘勇 方继良[1] SUN Jifei;HE Jiakai;CHEN Limei;WANG Zhi;GUO Chunlei;MA Yue;LUO Yi;LI Xiaojiao;XU Ke;LIU Yong;FANG Jiliang(Department of Radiology,Guang’anmen Hospital of Chinese Academy of Traditional Chinese Medicine,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]中国中医科学院针灸研究所,北京100700 [3]西南医科大学附属中医医院放射科,四川泸州646000

出　　处：《中国中西医结合影像学杂志》2022年第1期11-15,共5页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：科技部国家重点研发计划(2018YFC1705802);国家自然科学基金面上项目(81774433,82174282);中国中医科学院科技创新工程(461092)。

摘　　要：目的:观察耳甲电针[经皮耳迷走神经刺激术(taVNS)]对复发性抑郁症患者静息态fMRI脑功能活动的即刻调节作用。方法:收集30例复发性抑郁症患者(患者组)及30例健康者(健康组),2组性别、年龄及受教育程度相匹配。患者组采用taVNS治疗30 min,并于治疗前后行静息态fMRI扫描;健康组仅行一次静息态fMRI扫描。观察比较2组全脑范围内的低频振荡振幅(ALFF)差异,以及taVNS治疗前后患者全脑范围内ALFF值的变化。结果:与健康组相比,患者组左侧内侧额上回/左侧内侧眶部额上回、右侧角回/右侧枕中回ALFF值升高,双侧中央前回、左侧楔前叶/左侧旁中央小叶ALFF值减低。患者组即刻治疗后与治疗前相比,右侧中央前回、左侧旁中央小叶/左侧楔前叶ALFF值升高,左侧前扣带回/左侧内侧眶部额上回、左侧枕中回/左侧角回ALFF值减低。结论:复发性抑郁症患者存在默认网络、视觉加工脑区及体感运动脑区脑功能异常,taVNS对以上大部分脑区有即刻调节作用,这可能是其治疗复发性抑郁症潜在的脑网络机制。Objective:To observe the immediate regulatory brain effect of transcutaneous auricular vagus nerve stimulation(taVNS)on resting-state fMRI in patients with recurrent depression.Methods:30 patients with recurrent depression(case group)and 30 healthy subjects(control group)were recruited.The two groups were matched in gender,age and education.The case group were treated with taVNS for 30 minutes,and underwent resting-state fMRI before and after treatment.The control group was only conducted the resting-state fMRI scan once.The difference of amplitude of low frequency fluctuation(ALFF)was compared between the two groups before and after taVNS treatment.Results:Compared with the control group,ALFF signal in the case group increased in the left medial superior frontal gyrus/left medial orbital superior frontal gyrus,right angular gyrus/right middle occipital gyrus,and decreased in the bilateral anterior central gyrus and left precuneus/left paracentral lobule.After the immediate treatment to the case group,ALFF signal increased in the right anterior central gyrus,left paracentral lobule/left precuneus,and decreased in the left anterior cingulate gyrus/left medial orbital superior frontal gyrus,left middle occipital gyrus/left angular gyrus.Conclusions:There are brain functional abnormalities in default network brain area,visual processing brain area and somatosensory motor brain area.And taVNS has an immediate regulatory effect on most of these brain regions,which may be an effective potential brain network mechanism for the treatment of recurrent depression.

关 键 词：针刺 耳 电针 抑郁症 磁共振成像 低频振荡振幅 默认网络 

分 类 号：R246.6[医药卫生—针灸推拿学] R445.2[医药卫生—中医临床基础]