电针率谷穴任务对偏头痛患者疼痛相关脑网络的影响  

Effects of Electroacupuncture on Shuaigu on Pain-related Functional Network of Migraine Patients:a Task-fMRI Study

作　　者：罗诗蕾 刘姗姗 魏翔宇 陈义磊 詹松华[1] LUO Shilei;LIU Shanshan;WEI Xiangyu;CHEN Yilei;ZHAN Songhua(Department of Radiology,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Acupuncture,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)

机构地区：[1]上海中医药大学附属曙光医院放射科,上海201203 [2]上海中医药大学附属曙光医院针灸科,上海201203

出　　处：《中国中医基础医学杂志》2022年第9期1483-1487,共5页JOURNAL OF BASIC CHINESE MEDICINE

基　　金：上海市2018年度“科技创新行动计划”临床医学领域项目(18401970300)-针灸治疗血管性痴呆脑效应机制研究;上海市2018年度“科技创新行动计划”临床医学领域项目(18401970900)-针灸防治偏头痛临床优选方案研究。

摘　　要：目的:基于任务态功能磁共振方法,从疼痛相关脑功能网络层面探究电针率谷穴的特异性中枢响应机制。方法:20例偏头痛患者行静息态及电针率谷穴任务态扫描,20例健康受试者行静息态功能磁共振扫描,应用SPM12软件选取前扣带回作为种子点,分析2组受试者针刺前、患者组电针即刻及电针前后前扣带回与全脑功能连接的变化差异。以RESTplus软件提取感兴趣区血氧水平值,与患者临床资料做相关性分析。结果:(1)患者组电针前与对照组比较,右侧前扣带回与右侧枕中回,左侧尾状核,左内侧额上回,左侧中央前回,右侧额中回,左侧额中回之间的功能连接减弱;左侧前扣带回与全脑功能连接未见明显差异;(2)电针刺激阶段,患者组左侧额下回三角部、左侧中央前回、左侧中央后回、右侧中央沟、右侧缘上回出现正激活;(3)患者组电针前后对照,左侧前扣带回与左侧三角部额下回,左右额中回功能连接增强;右侧前扣带回与左侧三角部额下回,左侧额上回,左右额中回功能连接增强;(4)背外侧前额叶皮层激活强度与患者病程年长呈负相关。结论:电针率谷穴能调制前扣带回与执行控制网络的功能连接,可能是其治疗偏头痛的中枢机制之一。Objective:In order to investigate the specificity mechanism of electro-acupuncture(EA)in GB8 on pain-related functional network of MA patients.Methods:20 patients with migraine were selected as the patient group and 20 healthy subjects as the control group.The patient group underwent resting state and task-related functional magnetic resonance imaging(fMRI)scanning at GB8 before and during EA treatment,while the control group receives scanning without EA.All the data were processed by SPM12 and REST plus.The anterior cingulate cortex(ACC)was selected as the seed point.The changes of FC between the ACC and the whole brain in the patient group and control group were analyzed in turn.The blood oxygen level-dependent(BOLD)value of dorsolateral prefrontal cortex(dlPFC)was analyzed with clinical data of patients.Results:(1)Compared with the control group,the functional connectivity(FC)values were weakened between the right ACC and right middle occipital gyrus,left caudate nucleus,left medial superior frontal gyrus,left anterior central gyrus,right middle frontal gyrus and left middle frontal gyrus in the patient group before EA state;(2)The increase of BOLD values in left pars triangularis of frontal inferior gyrus(BA46),left anterior central gyrus,left posterior gyrus,right Rolandic operculum and right supramarginal gyrus was observed at the EA Stimulates segment of patients group.(3)Compared with the phase of before EA in patient group,the FC values between left ACC and left pars triangularis,left and right middle frontal gyrus was enhanced were enhanced;the right ACC and left pars triangularis,left superior frontal gyrus,left and right middle frontal gyrus were enhanced.(4)The BOLD values in the dlPFC were negatively correlated with the duration of disease.Conclusion:Acupuncture at GB8 acupoint can modulate the FC between the ACC and executive control network(ECN),which may be the potential mechanisms of acupuncture at GB8 against migraine.

关 键 词：偏头痛 FMRI 率谷穴 任务态 功能连接 脑功能网络 执行控制网络 

分 类 号：R245.97[医药卫生—针灸推拿学]