针刺治疗缺血性脑卒中运动功能障碍康复BOLD-fMRI研究进展  

Progress of BOLD-fMRI study on rehabilitation of motor dysfunction in ischemic stroke treated with acupuncture

作　　者：朱力 余成新[1,2] ZHU Li;YU Chengxin(The First College of Clinical Medical Science,China Three Gorges University,Yichang 443000,China;Department of Radiology,Yichang Central People's Hospital,Yichang 443000,China)

机构地区：[1]三峡大学第一临床医学院,宜昌443000 [2]湖北省宜昌市中心人民医院放射科,宜昌443000

出　　处：《磁共振成像》2023年第4期132-136,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：北京医学奖励基金会基金(编号:YXJL-2022-0105-0134)。

摘　　要：缺血性脑卒中(ischemic stroke, IS)为我国首要致死致残疾病,70%患者并发运动功能障碍,针刺已成为一项早期重要辅助治疗手段。近年来,血氧水平依赖功能磁共振成像已成为研究针刺卒中的最常用方法。本研究从局部一致性、低频振幅等代表的局部功能传统体素分析和动态功能连接(dynamic functional connection, DFC)分析、图论分析等代表的复杂全脑网络分析研究成果比较入手,综述了针刺IS运动功能障碍研究从局部功能延伸至全脑功能分析,从体素研究向脑网络研究转化,并正在进一步向全脑整体网络研究深入的转变历程及利弊,进而提出目前该类研究已从基于单纯感觉运动网络(sensory motor network, SMN)映射的运动完成研究逐步过渡到基于默认网络(default mode network, DMN)映射的运动认知研究,但尚未完全普及。本综述为针刺IS运动功能障碍研究提供如灵活运用任务设计,围绕SMN及DMN双动态网络,采用DFC、图论等全脑网络分析针刺前后运动功能连接及属性变化等方法学指导及理论支持,从而更好地阐释针刺IS运动功能障碍康复机制并指导临床。Ischemic stroke(IS)is the leading cause of death and disability in China,with 70%of patients suffering from motor dysfunction,and acupuncture has become a vital early adjuvant therapy.In recent years,blood oxygenation level dependent-functional magnetic resonance imaging has become the most commonly used method to study acupuncture stroke.In this review,a comparison between the research results of regional functional traditional voxel analysis represented by regional homogeneityas well as amplitude of low-frequency fluctuation,and that of complex global cerebral network represented by dynamic functional connection(DFC)analysis as well as graph theoretical analysis were conducted.Also,the research transition of acupuncture treatment for IS motor dysfunction from regional function to global cerebral,from voxel analysis to brain network,and further toward global cerebral network research,together with its merits and limitations were explained.It is proposed that there had been a gradual transition of focus from research on motor completion based on pure sensory motor network(SMN)mapping to that on motor cognition based on default mode network(DMN)mapping,but it was not yet fully popularized.This review provides methodological guidance and theoretical support for the study of acupuncture for IS motor dysfunction,such as flexible use of task design,dual dynamic networks around SMN and DMN,and the use of global cerebral network analysis such as DFC and graph theory to analyze the changes in motor connectivity and properties before and after acupuncture,in order to better explain the acupuncture's rehabilitation mechanism for IS motor dysfunction as clinical guidance.

关 键 词：针刺 缺血性脑卒中 运动功能康复机制 血氧水平依赖功能磁共振成像 脑网络 运动认知 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]